Abstract

Purpose: Insertion achilles tendinitis recalcitrant to conservative care may require surgical interventiodouble-row repair technique has been shown to have biomechanical advantages in cadaveric studies and rehabilitation advantages in clinical studies. The addition of a flexor hallucis longus tendon transfer has been advocated in certain instances, but studies have called into question the benefit of this transfer. A retrospective study of patients that had undergone a double-row achilles tendon reattachment was performed comparing those with and without an adjunctive transfer. Fifty-one patients were included, 19 in the group with transfer and 32 in the group without transfer. Time to weight bearing in a boot and a brace were similar between groups but return to normal activity was faster in the group without transfer (145 days vs. 186 days, p=0.05). The group with the transfer was similar in regards to BMI but did skew older (52.3 years vs. 59.5 years, p=0.01). No other differences between the groups were found, including satisfaction, complications/revisions, and other demographics. The addition of a flexor hallucis longus transfer did not lead to increased complications but did not show a clear benefit either. The recovery was slower with the transfer, but this may correlate with the increased age in this group.