Quadriceps tendon autograft and platelet rich plasma injection to treat chronic Achilles tears-a minimum two-year follow-up.

BACKGROUND: The possibility of using a bone-tendon quadriceps tendon graft and platelet rich plasma (PRP) injection to enhance healing capability, to solve the defect created by stump retraction in chronic Achilles tendon ruptures was studied in a series of 8 patients. METHODS: A series of 8 patients studied prospectively and followed for more than 24 months is presented. Results were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) score, and evaluating pain, level of activity, footwear restrictions, and satisfaction. Statistical analysis was done by the sign test for matched pairs and Wilcoxon signed-rank test. Alpha error was set at 0.05. RESULTS: Preoperatively, patients showed an average AOFAS score of 77.25 (range, 67-88). After surgery, AOFAS score showed a marked improvement in all the cases, with an average of 95.6 (range, 87-100). Improvement in AOFAS score results was statistically significant, both for sign test for matched pairs (P=0.008) and for Wilcoxon signed-rank test (P=0.012). All of the patients were satisfied with the results of the procedure, and would undergo it again. CONCLUSIONS: Autologous quadriceps tendon graft (in bone-tendon configuration) has proved as a simple technique that offers good results to patients with tissue defects in the Achilles tendon.

Quadriceps autograft to treat Achilles Chronic tears: a simple surgical technique.

BACKGROUND: Chronic Achilles tendon tears could hinder patients and represent a challenge to surgeons. Although many different surgical techniques have been proposed for reconstruction of a neglected Achilles tendon rupture, there is no clear evidence to support one technique over the others, but the use of a technique that could allow for an "anatomical" reconstructions seems desirable. METHODS: The present paper describes a new anatomic Achilles tendon reconstruction for chronic tears, using a quadriceps tendon autograft as graft source, with PRP injected into the graft and the neighbor tissue, and fixation in a bone trough with a simple small fragments screw. RESULTS: Autologous quadriceps tendon graft seems an excellent option, although -surprisingly- has received little attention until now. CONCLUSIONS: Autologous Quadriceps tendon graft (in bone-tendon configuration) is a simple technique that could allow surgeons to reconstruct tissue defects in the Achilles tendon with non-expensive hardware.