Chronic Tibialis Anterior Tendon Tear Treated With an Achilles Tendon Allograft Technique
Abstract
Tibialis anterior tendon tear is an uncommon injury. Nontraumatic or degenerative tears are usually seen in the avascular zone of the tendon. Treatment can be conservative or surgical. Conservative treatment is adequate for low-demand older patients. For active patients, surgical treatment can be challenging for the surgeon because after debridement of degenerative tissue, a gap may be formed that can make side-to-side suture impossible. The authors present allograft Achilles tendon insertion for reconstruction of chronic degenerative tears. Using Achilles tendon allograft has the advantage of bone-to-bone fixation, allowing rapid incorporation and earlier full weight bearing.
- 1.Brüning F. Zwei seltene Fälle von subkutaner Sehnenzerreissung. München Med Wchschr. 1905; 52:1928–1929. Google Scholar
- 2.Scott TA, Sammarco JG, Sammarco JV. Surgical repair of tibialis anterior tendon rupture. Tech Foot Ankle Surg. 2012; 11:39–44.
10.1097/BTF.0b013e31824695e7 Crossref, Google Scholar - 3.Crosby LA, Fitzgibbons TC. Unrecognized laceration of tibialis anterior tendon: a case report. Foot Ankle. 1988; 9:143–145.
10.1177/107110078800900310 Crossref Medline, Google Scholar - 4.Din R, Therkilsden L. Rupture of tibialis anterior associated with a closed midshaft tibial fracture. J Accid Emerg Med. 1999; 16:459.
10.1136/emj.16.6.459 Crossref Medline, Google Scholar - 5.Forst R, Forst J, Heller KD. Ipsilateral peroneus brevis tendon grafting in a complicated case of traumatic rupture of tibialis anterior tendon. Foot Ankle Int. 1995; 16:440–444.
10.1177/107110079501600712 Crossref Medline, Google Scholar - 6.Sammarco VJ, Sammarco GJ, Henning C, Chaim S. Surgical repair of acute and chronic tibialis anterior tendon ruptures. J Bone Joint Surg Am. 2009; 91:325–332.
10.2106/JBJS.G.01386 Crossref Medline, Google Scholar - 7.Bernstein RM. Spontaneous rupture of the tibialis anterior tendon. Am J Orthop (Belle Mead NJ). 1995; 24:354–356. Medline, Google Scholar
- 8.Dooley BJ, Kudelka P, Menelaus MB. Subcutaneous rupture of the tendon of tibialis anterior. J Bone Joint Surg Br. 1980; 62:471–472. Crossref Medline, Google Scholar
- 9.Anagnostakos K, Bachelier F, Fürst OA, Kelm J. Rupture of the anterior tibial tendon: three clinical cases, anatomical study, and literature review. Foot Ankle Int. 2006; 27:330–339. Crossref Medline, Google Scholar
- 10.Petersen W, Stein V, Tillmann B. Blood supply of the tibialis anterior tendon. Arch Orthop Trauma Surg. 1999; 119:371–375.
10.1007/s004020050431 Crossref Medline, Google Scholar - 11.Cirincione RJ, Baker BE. Tendon ruptures with secondary hyperparathyreoidism. A case report. J Bone Joint Surg Am. 1975; 57:852–853. Crossref Medline, Google Scholar
- 12.Murphy KJ, McPhee . Tears of major tendons in chronic acidosis with elastosis. J Bone Joint Surg Am. 1965; 47:1253–1258. Crossref Medline, Google Scholar
- 13.Ford LT, DeBender J. Tendon rupture after local steroid injection. South Med J. 1979; 72:827–830.
10.1097/00007611-197907000-00019 Crossref Medline, Google Scholar - 14.Velan GJ, Hendel D. Degenerative tear of the tibialis anterior tendon after corticosteroid injection—augmentation with the extensor hallucis longus tendon, case report. Acta Orthop Scand. 1997; 68:308–309.
10.3109/17453679708996711 Crossref Medline, Google Scholar - 15.Kaleagasioglu F, Olcay E. Fluoroquinolone-induced tendinopathy: etiology and preventive measures. Tohoku J Exp Med. 2012; 226:251–258.
10.1620/tjem.226.251 Crossref Medline, Google Scholar - 16.Kashyap S, Prince R. Spotaneous rupture of the tibialis anterior. Clin Orthop Relat Res. 1987; 216:159–161. Crossref, Google Scholar
- 17.Otte S, Klinger HM, Lorenz F, Haerer T. Operative treatment in case of a closed rupture of the anterior tibial tendon. Arch Orthop Trauma Surg. 2002; 122:188–190.
10.1007/s004020100346 Crossref Medline, Google Scholar - 18.Aydingöz U, Aydingöz O. Spontaneous rupture of the tibialis anterior tendon in a patient with psoriasis. Clin Imaging. 2002; 26:209–211.
10.1016/S0899-7071(01)00381-3 Crossref Medline, Google Scholar - 19.Patten A, Pun WK. Spontaneous rupture of the tibialis anterior tendon: a case report and literature review. Foot Ankle Int. 2000; 21:697–700. Crossref Medline, Google Scholar
- 20.Jerome JT, Varghese M, Sankaran B, Thomas S, Thirumagal SK. Tibialis anterior tendon rupture in gout—case report and literature review. Foot Ankle Surg. 2008; 14:166–169.
10.1016/j.fas.2007.12.001 Crossref Medline, Google Scholar - 21.Gallo RA, Kolman BH, Daffner RH, Sciulli RL, Roberts CC, DeMeo PJ. MRI of tibialis anterior tendon rupture. Skeletal Radiol. 2004; 33:102–106.
10.1007/s00256-003-0713-2 Crossref Medline, Google Scholar - 22.Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994; 15:349–353.
10.1177/107110079401500701 Crossref Medline, Google Scholar - 23.Martin RL, Burdett RG, Irrgang JJ. Development of the Foot and Ankle Disability Index (FADI)J Orthop Sports Phys Ther. 1999; 29:A32–A33. Google Scholar
- 24.Sammarco VJ, Sammarco GJ, Henning C, Chaim S. Injuries to tibialis anterior, peroneal tendons, and long flexors and extensors of the toes. In: , eds. Baxter’s The Foot and Ankle in Sport. 2nd ed. Philadelphia, PA: Mosby Elsevier; 2008:121–146.
10.1016/B978-032302358-0.10006-5 Crossref, Google Scholar - 25.Khoury NJ, el-Khoury GY, Saltzman CL, Brandser EA. Rupture of the anterior tibial tendon: diagnosis by MR imaging. AJR Am J Roentgenol. 1996; 167:351–354.
10.2214/ajr.167.2.8686602 Crossref Medline, Google Scholar - 26.Markarian GG, Kelikian AS, Brage M, Trainor T, Dias L. Anterior tibialis tendon ruptures: an outcome analysis of operative versus nonoperative treatment. Foot Ankle Int. 1998; 19:792–802.
10.1177/107110079801901202 Crossref Medline, Google Scholar - 27.Ouzounian TJ, Anderson R. Anterior tibial tendon rupture. Foot Ankle Int. 1995; 16:406–410.
10.1177/107110079501600705 Crossref Medline, Google Scholar - 28.Ahn JH, Yoo JC, Wang JH. Posterior cruciate ligament reconstruction: double-loop hamstring tendon autograft versus Achilles tendon allograft—clinical results of a minimum 2-year follow-up. Arthroscopy. 2005; 21:965–969.
10.1016/j.arthro.2005.05.004 Crossref Medline, Google Scholar - 29.Lee MC, Park YK, Lee SH, Jo H. Posterolateral reconstruction using split Achilles tendon allograft. Arthroscopy. Arthroscopy. 2003; 19:1043–1049.
10.1016/j.arthro.2003.09.037 Crossref Medline, Google Scholar - 30.Sanchez-Sotelo J, Morrey BF, Adams RA, O’Driscoll SW. Reconstruction of chronic ruptures of the distal biceps tendon with use of an Achilles tendon allograft. J Bone Joint Surg Am. 2002; 84:999–1005.
10.1302/0301-620X.84B8.12902 Crossref Medline, Google Scholar - 31.Crossett LS, Sinha RK, Sechriest VF, Rubash HE. Reconstruction of a ruptured patellar tendon with Achilles tendon allograft following total knee arthroplasty. J Bone Joint Surg Am. 2002; 84:1354–1361. Crossref Medline, Google Scholar
- 32.Fehm MN, Huddleston JI, Burke DW, Geller JA, Malchau H. Repair of a deficient abductor mechanism with Achilles tendon allograft after total hip replacement. J Bone Joint Surg Am. 2010; 92:2305–2311.
10.2106/JBJS.I.01011 Crossref Medline, Google Scholar - 33.Marx RG, Hetsroni I. Surgical technique: medial collateral ligament reconstruction using Achilles allograft for combined knee ligament injury. Clin Orthop Relat Res. 2012; 470:798–805.
10.1007/s11999-011-1941-8 Crossref Medline, Google Scholar

