V-Y tendon advancement in patients with chronic retracted tendo-Achilles rupture: functional and clinical outcomes

Abstract

Chronic Achilles tendon rupture is a relatively uncommon disabling condition, often due to delayed diagnosis or missed treatment. Primary repair is often complicated by retraction of the tendon, scar tissue formation and shortening of the gastrocnemius-soleus complex. The V-Y tendon advancement is a useful reconstructive technique that allows reconstruction of tendon continuity without the need for tendon grafts or tendon transfers. In our study we aimed to evaluate the clinical and functional outcome of V-Y tendon advancement in patients with chronic retracted tendo Achilles rupture. We conducted a retrospective observational study of 15 patients treated with V-Y tendon advancement for chronic Achilles tendon rupture from January 2020 to December 2025. Functional results were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Achilles Tendon Total Rupture Score (ATRS). Heel-rise ability, ankle range of motion, return to daily activities and postoperative complications were recorded as clinical outcomes. The patients’ mean age was 48.7 years and the mean duration of follow-up was 16.7 months. Average tendon defect after debridement was 5.2 cm. The average AOFAS score improved from 44.3 preoperatively to 88.9 at final follow-up. The average ATRS score was 83.9. Eleven patients (73.3%) were able to repeat a single heel-rise test. The most common complication was mild ankle stiffness. There was no re-rupture of the tendons. Thus, we concluded that, V-Y tendon advancement is a reliable and effective technique for reconstruction of chronic retracted Achilles tendon rupture the procedure leads to satisfactory functional outcome, restoration of gait and low complication rate.