Hamstring Reconstruction for Chronic Achilles Pathology

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There are many accepted treatment options for chronic tears of the Achilles tendon. In cases involving a tendon gap of over 5 cm after debridement and removal of unhealthy tissue, a primary tendon reconstruction is recommended, as there is not enough healthy tissue to perform a direct repair. Various tendons have been used, including the peroneal tendons, the Flexor Hallucis Longus (FHL), as well as allografts including use of the Achilles, FHL, flexor digitorum longus, and semitendinosus tendons. We propose the use of a hamstring autograft, using both gracilis and semitendinosus. In addition, if the patient is young and active and hoping to return to sports, we recommended augmenting the Achilles reconstruction by transferring an FHL tendon to help restore full strength.

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