Reconstruction of Neglected or Chronic Achilles Tendon Defects Using Peroneus Brevis Tendon Allograft — A Clinical Study

Abstract

Introduction: Achilles tendon ruptures, especially neglected or chronic cases, present significant challenges in reconstructive surgery, often requiring robust grafting options. The Peroneus Brevis tendon allograft has emerged as a potential alternative due to its anatomical and biomechanical properties. Methods & Materials: This retrospective study included 25 patients with neglected or chronic Achilles tendon ruptures who underwent reconstruction using the Peroneus Brevis tendon allograft. Preoperative imaging included radiographic and MRI assessments, while intraoperative evaluation focused on graft suitability and the need for soft tissue augmentation. Postoperative assessments were conducted at 3, 6, and 12 months, with outcomes measured through AOFAS scores, range of motion, and patient satisfaction. Statistical analysis was performed using SPSS version 26. Results: The majority of patients were middle-aged males, with the right side more frequently affected. Preoperative imaging revealed large tendon defects in 40% of cases and moderate defects in 48%. Intraoperative findings confirmed adequate graft length and quality in 92% of cases, with only 8% requiring additional grafts. Complications were minimal, with infection in 8% of patients, graft rejection in 4%, and re-rupture in 4%. At 12 months, 68% of patients achieved excellent AOFAS scores, with 76% reporting high satisfaction. Conclusion: The Peroneus Brevis tendon allograft offers a safe and effective solution for reconstructing neglected or chronic Achilles tendon defects, demonstrating high functional recovery and patient satisfaction with low complication rates. This technique provides a viable option for complex Achilles repairs, particularly in settings with limited resources.