Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

Study Overview
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Brief Summary
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This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon.

Detailed Description
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This study aims to provide a new therapeutic theory which bases on the percutaneous sliding technique with three hemi-cuts in the tendon. In this study, Achilles tendon parenchymal at distal level is hemisected through the most distal incision, Achilles tendon parenchymal at proximal level is hemisected through the middle incision, then Achilles tendon lengthening is accomplished by the sliding tendon under forceful dorsiflexion. It can better achieve soft tissue balance and reduce the recurrence of Achilles tendon contracture when Achilles tendon strength in plantarflexion is weakened. Thus in this study, the partial aponeurosis of gastrocnemius is cut off at most proximal incision in order to weaken Achilles tendon strength in plantarflexion.

Official Title
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Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

Conditions
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Achilles Tendon Contracture

Intervention / Treatment
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* Procedure: Achilles tendon lengthening


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients older than three years old; Severe Achilles tendon contracture and equinus; The time after Achilles tendon contracture more than 6 months ; Initial Achilles tendon lengthening. Exclusion Criteria: Patients younger than 3 years; The course of Achilles tendon contracture is within 6 months; Patients who have suffered from the Achilles tendon lengthening; Obvious contracture of other soft tissues occurs in combination, such as compartment syndrome or extensive scar tissues in calf; Osteotomy or tendon transposition is needed. Ankle joint is damaged obviously, such as Charcot's joint or Hemophilic arthritis; Skin soft-tissue infection in the lower limb. Initial Achilles tendon lengthening.

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Achilles tendon lengthening<br>Surgery of percutaneous Achilles tendon lengthening by triple hemisection | Procedure: Achilles tendon lengthening<br>* Achilles tendon lengthening by triple hemisection for Achilles tendon contracture<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in the American Orthopaedic Foot & Ankle Society (AOFAS) scores | The AOFAS scores of the patients before and after surgery are recorded. The scale ranges from 0-100 points, and increases of the value represent a better outcome. | Before surgery and up to 8 years after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Equinus recurrence rate | The equinus recurrence rate of the patients after surgery is recorded. Lower value represents a better outcome. | Up to 8 years after surgery | 
| Infection rate | The infection rate of the patients after surgery is recorded. Lower value represents a better outcome. | Up to 8 years after surgery |