Background: There are some cases with chronic Achilles tendon (AT) rupture with defects >6 cm which local tendons are insufficient to bridge the gap. The purpose of this study was to evaluate the clinical and functional outcomes following reconstruction of the chronic AT ruptures with large gap usingfree semitendinosus tendon graft transfer.

Materials and methods: Between 2004 and 2008, 11 men with chronic AT rupture, aged 30±3.97 years were Sampled. The average length of the defect was 8.31±1.96 cm. The tendon of semitendinosus was harvested to reconstruct AT. We used American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hind Foot Scale and the Achilles Tendon Rupture Score (ATRS) to evaluate the clinical and functional outcomes.Patients were followed for 25.36±3.35 months.

Results: The average AOFAS and ATRS improved from 70.45±5.29 and 31.73±5.67 preoperatively, to 91.82±4.77 and 88.73±4.17 points postoperatively. There were statistically significant differences between pre- and post-operative scores (p=0.000). The range of dorsiflexion was significantly limited on the operated side (13.5±4.2 vs. 17.2±3.9 degrees) (p=0.04). All patients, except one who was a professional athlete, returned to their previous activities. Postoperative complications included one case with DVT and 2 cases with superficial infection treated with drug therapy. In addition, 3 patients had difficulty wearing shoes.

Conclusion: This technique offers Droper clinical and functional results in patients with large defects and is associated with no harvesting morbidity. We Suggest Utilizing this technique for the reconstruction of the chronic AT ruptures in patients with defects >6 cm.