Tibialis Anterior Tendon Reconstruction Using Augmented Half-Thickness Tendon Segment Transposition

Tibialis anterior tendon rupture causes substantial morbidity. The present study describes the outcomes of augmented, half-thickness tibialis anterior tendon segment transposition, a novel reconstruction technique. This was an institutional review board–approved retrospective review of 3 patients with surgically treated attritional distal rupture with 1-year follow-up. The postdebridement tendon defect prohibited primary repair and was managed by distal transposition of a half-thickness healthy segment. This repair was augmented with human acellular dermal matrix allograft (Graftjacket, Wright Medical Technology, Memphis, TN). The mean age was 68 years (range, 59-73 years). Mean interval between injury and surgery was 59.3 days (range, 15-146 days). All patients regained symmetrical range of motion, motor power, and the ability to heel walk. Mean pain scores improved from 4.6 (range, 2.5-8.5) preoperatively to 0.7 (range, 0-2) postoperatively. Mean Foot and Ankle Ability Measure scores increased from 30.6 (range, 23.8-43.8) preoperatively to 78.7 (range, 72.6-97.6) postoperatively. No postoperative complications occurred. One patient was satisfied and 2 were very satisfied with their outcome. Although limited, the present findings appear to indicate that this technique produces short-term clinical results comparable to those described for other techniques for tibialis anterior tendon reconstruction. Levels of Evidence: Therapeutic, Level IV.