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Hamstring Autograft Reconstruction of the Anterior Tibial Tendon

Karnovsky, Sydney C. BA; Drakos, Mark C. MD
Techniques in Foot & Ankle Surgery: Post Author Corrections: September 13, 2017
doi: 10.1097/BTF.0000000000000172
Special Focus: PDF Only

Injuries to the tibialis anterior tendon (TAT) are rarely reported in the literature, and, in existing reports, there are varied treatment options. Many authors recommend operative treatment over conservative treatment in young, healthy, and active patients, in order to give the patient as much strength back as possible and to allow them to avoid the use of a brace. Different types of operative repair have been described, including: extensor digitorum longus transfer, extensor hallucis longus transfer, plantaris transfer, Achilles autograft, as well as gracilis and semitendinosus autografts and allografts. We advocate using a hamstring autograft, either gracilis in isolation, semitendinosus in isolation, or a combination of the 2, depending on the size of the patient’s tendons, to operatively reconstruct ruptured TATs.

Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

All patients were enrolled in our tibialis anterior strength testing study as well as our department’s Foot and Ankle Registry. Both our study and registry are approved by our institution’s IRB and all patients were consented following our IRB’s consenting protocol.

M.C.D.: is a paid consultant for Extremity Medical and Fast Form, neither of whose products are involved in the current paper. S.C.K. declares no conflict of interest.

Address correspondence and reprint requests to Mark C. Drakos, MD, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021. E-mail:

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