SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Free tendon grafts for surgical management of chronic tears of the main body of the Achilles tendon: a systematic review.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Surgical management of chronic Achilles tendon rupture: evidence-based guidelines.Journal of orthopaedic surgery and research · 2024Pooled it
- Polydeoxyribonucleotide improves scar healing following limited scar resection for chronic Achilles tendon rupture in a rat model.Journal of orthopaedic surgery and research · 2026Article
- Proximal hamstring reconstruction with a semitendinosus tendon allograft exhibits superior time-zero biomechanical properties compared to reconstruction with an Achilles tendon allograft.Bone & joint research · 2026Article
- Reconstruction of Chronic Achilles Tendon Ruptures with Hamstring Autografts: Plantar Flexor Strength Is Preserved Despite Shortening of the Moment Arm.Journal of clinical medicine · 2026Article
- Achilles tendon ruptures: still very much in the limelight, and still controversial. Not all research is as glittering as it may look.Journal of orthopaedic surgery and research · 2026Article
- Endoscopic flexor hallucis longus transfer in the patients with chronic achilles rupture.Journal of orthopaedic surgery and research · 2026Article
- Isolated Flexor Hallucis Longus Tendon Transfer for Chronic Achilles Tendon Rupture: Systematic Review and Meta-Analysis.Healthcare (Basel, Switzerland) · 2025Review
- Minimum 5-Year Outcomes After Minimally Invasive Achilles Tendon Reconstruction Using Autologous Hamstring Grafts.Foot & ankle orthopaedics · 2025Article
- Reconstruction of Chronic Quadriceps and Achilles Tendon Ruptures Using Achilles Allografts: Clinical Findings and Review of Literature.Biomedicines · 2025Article
- Therapeutic effects of chitosan/β-glycerophosphate/collagen hydrogel combined with MSCs on chronic achilles tendon injury via the Akt/GSK-3β pathway.Journal of orthopaedic surgery and research · 2025Article
- Ultrasound assessment of acute Achilles tendon rupture and measurement of the tendon gap.Australasian journal of ultrasound in medicine · 2024Review
- Modified gastro-soleus turn-down flap for chronic or neglected achilles tendon ruptures.Journal of orthopaedic surgery and research · 2024Article
- A comprehensive review of surgical techniques for chronic Achilles tendon rupture.Tzu chi medical journalReview
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAfter four weeks from injury, tears of the Achilles tendon are considered chronic. Their management is challenging, and the use of a graft is suggested when the gap between proximal and distal stumps is greater than 6 cm. The present study systematically reviews the outcome of free tendon grafts in chronic ruptures of the Achilles tendon, evaluating clinical outcomes, complications and return to sport.
methodsThe present study was conducted according to the PRISMA 2020 guidelines. PubMed, Google Scholar, Embase, and Web of Science databases were accessed in February 2023. All the published clinical studies reporting clinical outcome, return to sport and complications of free tendon grafts used the treatment of chronic rupture of the midportion of the Achilles Tendon were accessed. The mean CMS (Coleman Methodology Score) of 65.7 suggested an overall good quality of the available published articles, attesting to the low risk of bias.
resultsData from 22 articles (368 patients with a mean age of 47 years) were retrieved. The average time from rupture to surgery was 25.1 week. At last follow-up, the AOFAS (American Orthopaedic Foot and Ankle Surgery) and ATRS (Achilles Tendon Total Rupture Score) scores improved of 33.8 (P = 0.0004), and 45.1 points (P = 0.0001) respectively. Return to activity was reported in 105 patients, and 82 (78.1%) had no activity limitations, while 19 (18.1%) had limited recreational but not daily activity limitations, and 4 (3.8%) reported limitations in daily activities. Return to sport data was reported in six studies, and 45 of 93 (48.4%) patients returned to sport at an average of 22.6 weeks.
conclusionIn chronic tears of the Achilles tendon, with a gap of at least 6 cm, free tendon grafts allow predictable return to sport and acceptable recovery function. LEVEL OF EVIDENCE: Level IV.
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