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Hamstring Reconstruction for Chronic Achilles Pathology

Karnovsky, Sydney C. BA; Drakos, Mark C. MD
Techniques in Foot & Ankle Surgery: Post Author Corrections: September 01, 2017
doi: 10.1097/BTF.0000000000000170
Special Focus: PDF Only

There are many accepted treatment options for chronic tears of the Achilles tendon. In cases involving a tendon gap of over 5 cm after debridement and removal of unhealthy tissue, a primary tendon reconstruction is recommended, as there is not enough healthy tissue to perform a direct repair. Various tendons have been used, including the peroneal tendons, the Flexor Hallucis Longus (FHL), as well as allografts including use of the Achilles, FHL, flexor digitorum longus, and semitendinosus tendons. We propose the use of a hamstring autograft, using both gracilis and semitendinosus. In addition, if the patient is young and active and hoping to return to sports, we recommended augmenting the Achilles reconstruction by transferring an FHL tendon to help restore full strength.

All patients were enrolled in our Hamstring Strength Study, which was approved by our IRB committee and each patient was consented to participate through the IRB protocol.

M.C.D. is a paid consultant for Extremity Medical and Fast Form, neither of whose products are involved in the current study. The other author declares no conflicts of interest.

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

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