Flexor hallucis longus tendon transfer: a definitive procedure for Achilles tendon tear in Achilles tendinopathy. A 2-year prospective study

Abstract

Background: Flexor hallucis longus (FHL) tendon transfer aims to relieve pain and restore function after Achilles tendon rupture in patients with Achilles tendinopathy. The choice of operative treatment for chronic Achilles tendon disease is based on the size of the tendon rupture. Our aim was to convey our experience in treating Achilles tendon rupture using FHL tendon transfer. Methods: This study included 22 patients (22 ankles) with Achilles tendon rupture after a history of Achilles tendinopathy in the form of ankle pain and edema for a mean period of 1 yr before trauma. Patients were followed for a mean period of 2 yr. The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score was used for outcome measurement. Results: Twenty-two patients (22 ankles) had FHL tendon transfer (mean age 50.3 yr, follow-up period 2 yr). The AOFAS score improved from 68.9 to 88 (P<0.001), revealing significant improvement in ankle pain, function, and stability. Conclusions: This study supports the concept that FHL tendon transfer for Achilles tendon rupture in patients with Achilles tendinopathy is the procedure of choice and provides excellent clinical and functional results. Level of Evidence: Level IV, prospective cohort study.