Table 2.
Summary of Study Characteristics and Outcomes.
| Author | Year | LOE | MCMS | Patients (n) |
Age (y) |
Follow-up (mo) | Technique | Time From Injury to Surgery (wk) | Length of Tendon Gap (cm) | Patient Outcomes | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Scores | Pre op. | Post op. | ||||||||||
| Takao et al 44 | 2003 | 4 | 57 | 10 | 51 | 75.1 | Gastrocnemius flap | 16 | AOFAS | 72.6 | 98.1 | |
| Jennings and Sefton 19 | 2002 | 4 | 61 | 16 | 52 | 36 | Polyester tape | 67.2 | Tegner | 2.7 | 1.8 | |
| Elias et al 10 | 2007 | 4 | 54 | 15 | 55.8 | 26.5 | V-Y and FHL transfer | 17.3 | 5.7 | AOFAS | 58.4 | 94.1 |
| VAS | 2.1 | 1.6 | ||||||||||
| Kosanović and Brilej 24 | 2008 | 4 | 54 | 18 | 50 | 67 | Percutaneous suturing of tendon | 7.1 | 5.7 | Tegner | 5.4 | 4.6 |
| Ibrahim 18 | 2009 | 4 | 51 | 14 | 41.6 | LARS | 15 | AOFAS | 48.6 | 85.9 | ||
| Tegner | 2.58 | 1.73 | ||||||||||
| El Shewy et al 8 | 2009 | 4 | 56 | 11 | 34.3 | 89.5 | Gastrocnemius flap | 7.3 | AOFAS | 42.3 | 98.9 | |
| Holz | 66 | 163 | ||||||||||
| Maffulli et al 32 | 2010 | 4 | 55 | 32 | 47.1 | 48.4 | PB transfer | 15.2 | ATRS | 92.5 | ||
| Sarzaeem et al 40 | 2012 | 4 | 53 | 11 | 30 | 25 | ST autograft | 48 | 8.3 | AOFAS | 70 | 92 |
| ATRS | 32 | 89 | ||||||||||
| Khiami et al 21 | 2013 | 4 | 53 | 23 | 52.1 | 24.5 | Free triceps sural aponeurosis | 53.6 | 5.7 | AOFAS | 63.6 | 96.1 |
| Maffulli et al 28 | 2013 | 4 | 65 | 26 | 42 | 98.4 | ST autograft | 15.2 | >6 cm | ATRS | 88 | |
| Maffulli et al 30 | 2013 | 4 | 56 | 28 | 46 | 31.4 | ST autograft | 116 | >6 cm | ATRS | 42 | 86 |
| Esenyel et al 12 | 2014 | 4 | 62 | 10 | 41 | 43.2 | Gastrocnemius flap | 7.6 | AOFAS | 64.8 | 97.8 | |
| El Shazly et al 7 | 2014 | 4 | 60 | 15 | 37.7 | 27 | ST autograft | 13.5 | 4.9 | AOFAS | 32.6 | 90.8 |
| Yasuda et al 47 | 2016 | 4 | 56 | 30 | 52.7 | 33 | Direct repair with scar tissue | 22 | 4.3 | AOFAS | 82.8 | 98.1 |
| ATRS | 92 | |||||||||||
| Ahmad et al 1 | 2016 | 4 | 58 | 32 | 53.3 | 62.3 | FHL transfer and Turndown of proximal, central Achilles | 14.6 | 7.5 | VAS | 6.6 | 1.8 |
| FAAM-Sports | 36.3 | 90.2 | ||||||||||
| Elgohary et al 9 | 2016 | 4 | 56 | 19 | 47 | 29 | FHL transfer and gastrocnemius recession |
16 | 6.8 | AOFAS | 65 | 94 |
| Gedam and Rushnaiwala 15 | 2016 | 3 | 46 | 14 | 45.6 | 30.1 | Gastrocnemius turndown flap and ST autograft | 22 | 5.1 | AOFAS | 64.5 | 96.9 |
| ATRS | 49.4 | 91.4 | ||||||||||
| Guclu et al 16 | 2016 | 3 | 55 | 17 | 33 | 195 | V-Y and fascia turndown | 28 | 6 | AOFAS | 64 | 95 |
| Seker et al 42 | 2016 | 4 | 62 | 21 | 32.1 | 145.3 | Gastrocnemius flap | 8.4 | 6.4 | AOFAS | 33 | 98.5 |
| FADI | 98.9 | |||||||||||
| VAS | 0 | |||||||||||
| Maffulli et al 31 (ST/PB/FHL) | 2018 | 4 | 60 | (21/21/20) | (45.7/45.8/42.7) | (34.1/36.4/35.8) | ST graft, PB transfer, FHL transfer | (15.6/17.2/14.8) | (>6 cm, <6 cm, <6 cm) | ATRS | (50.4/51.3/52.3) | (89.4/89.5/88.9) |
| Lever et al 25 | 2018 | 4 | 57 | 20 | 60 | 73 | FHL transfer | 28 | AOFAS | 94.3 | ||
| ATRS | 83 | |||||||||||
| SF-12 | 47.8 | |||||||||||
| Tegner | 5 | 4 | ||||||||||
| Vega et al 46 | 2018 | 4 | 53 | 22 | 69 | 30.5 | FHL transfer | 6.3 | AOFAS | 55 | 91 | |
| Song et al 43 | 2020 | 4 | 49 | 33 | 36.1 | 53 | ST allograft | 12 | – | AOFAS | 50 | 100 |
| ATRS | 22.5 | 99 | ||||||||||
| Tegner | 1 | 4 | ||||||||||
| VISA-A | 23 | 94 | ||||||||||
| Zou et al 48 | 2021 | 4 | 62 | 19 | 46.7 | 31 | Double-bundle FHL transfer | 14.7 | 5.5 | AOFAS | 52.1 | 97.5 |
| ATRS | 23.3 | 98.3 | ||||||||||
| VISA-A | 23.4 | 95.7 | ||||||||||
| Tsukada et al 45 | 2021 | 4 | 55 | 10 | 51.7 | 36.5 | ST autograft (Slide-locking loop suture - SLLS) |
28.8 | 5.29 | AOFAS | 64.2 | 95 |
| ATRS | 29.8 | 86.2 | ||||||||||
| Fischer et al 13 (FHL/PL) | 2021 | 3 | 52 | 60 (34/26) | 54.82 (57.29/51.58) | 49 | FHL transfer vs plantaris longus augmentation |
30.48 (29.87/31.62) | AOFAS | 87.80 (85.61/90.58) | ||
| VAS-FA | 78.07 (73.66/83.66) | |||||||||||
| SF-12 Phys | 48.21 (46.24/50.71) | |||||||||||
| SF-12 Ment | 54.10 (54.98/52.99) | |||||||||||
Abbreviations: AOFAS, American Orthopaedic Foot & Ankle Society; ATRS, Achilles tendon rupture score; FAAM, Foot and Ankle Ability Measure; FADI, Foot and Ankle Disability Index; FHL, flexor hallucis longus; LARS, ligament augmentation and reconstruction system; LOE, level of evidence; MCMS; Modified Coleman Methodological Score; PB, peroneus brevis; PL, peroneus longus; SF-12, 12-Item Short Form Health Survey; ST, semitendinosus; VAS, visual analog scale; VISA-A, Victorian Institute Society Australia–Achilles.