Chronic tendinopathy is characterized by pain in the tendon, generally at the start and completion of exercise. However, tendinosis may lead to decreased blood flow, increased stiffness of the tendon and reduced tensile strength, and predispose to rupture. Operative treatment is indicated to restore the function of the Achilles tendon and alleviate the prerupture heel cord pain. A case of acute Achilles tendon rupture with extensive tendinosis that was successfully treated with minimally invasive flexor hallucis longus transfer is reported.
TallonCMaffulliNEwenSW. Ruptured Achilles tendons are significantly more degenerated than tendinopathic tendons. Med Sci Sports Exer. 2001;33:1983-1990.
2.
HessGW. Achilles tendon rupture: a review of etiology, population, anatomy, risk factors, and injury prevention. Foot Ankle Spec. 2010;3:29-32.
3.
ZafarMSMahmoodAMaffulliN. Basic science and clinical aspects of Achilles tendinopathy. Sports Med Arthrosc. 2009;17:190-197.
4.
OhbergLLorentzonRAlfredsonH. Neovascularisation in Achilles tendons with painful tendinosis but not in normal tendons: an ultrasonographic investigation. Knee Surg Sports Traumatol Arthrosc. 2001;9:233-238.
5.
AnderssonGDanielsonPAlfredsonHForsgrenS. Nerve-related characteristics of ventral paratendinous tissue in chronic Achilles tendinosis. Knee Surg Sports Traumatol Arthrosc. 2007;15:1272-1279.
6.
BjurDAlfredsonHForsgrenS. The innervation pattern of the human Achilles tendon: studies of the normal and tendinosis tendon with markers for general and sensory innervations. Cell Tissue Res. 2005;320:201-206.
7.
SchubertTEWeidlerCLerchKHofstadterFStraubRH. Achilles tendinosis is associated with sprouting of substance P positive nerve fibres. Ann Rheumat Dis. 2005;64:1083-1086.
8.
WilcoxDKBohayDRAndersonJG. Treatment of chronic Achilles tendon disorders with flexor hallucis longus tendon transfer/augmentation. Foot Ankle Int. 2000;21:1004-1010.
9.
WongMWNNgVWS. Modified flexor hallucis longus transfer for Achilles insertional rupture in elderly patients. Clin Orthop Relat Res. 2005;431:201-206.
10.
MartinRLManningCMCarciaCRContiSF. An outcome study of chronic Achilles tendinosis after excision of the Achilles tendon and flexor hallucis longus tendon transfer. Foot Ankle Int. 2005;26:691-697.
11.
WegrzynJLucianiJFPhilippotRBrunet-GuedjEMoyenBBesseJL. Chronic Achilles tendon rupture reconstruction using a modified flexor hallucis longus transfer. Int Orthop. 2010;34:1187-1192.
12.
SuttinarkPSuebpongsiriP. Clinical outcomes of flexor hallucis longus transfer for the treatment of Achilles tendinosis rupture. J Med Assoc Thai. 2009;92(suppl 6):S226-S231.
13.
CottomJMHyerCFBerletGCLeeTH. Flexor hallucis tendon transfer with an interference screw for chronic Achilles tendinosis: a report of 62 cases. Foot Ankle Spec. 2008;1:280-287.
14.
HahnFMeyerPMaiwaldCZanettiMVienneP. Treatment of chronic Achilles tendinopathy and ruptures with flexor hallucis tendon transfer: clinical outcome and MRI findings. Foot Ankle Int. 2008;29:794-802.
15.
PanchbhaviVK. Chronic Achilles tendon repair with flexor hallucis longus tendon harvested using a minimally invasive technique. Tech Foot Ankle Surg. 2007;6:123-129.
16.
LuiTH. Whole length flexor hallucis longus transfer with a minimally invasive approach. Foot Ankle Int. 2011;32:730-734.
17.
MurphyRLWomackJWAndersonJT. Technique tip: a new technique for harvest of the flexor hallucis longus tendon. Foot Ankle Int. 2010;31:457-459.
