Tendon allograft for treatment of chronic Achilles tendon rupture: A systematic review

Background: To summarize available evidence and determine if tendon allograft is an effective treatment for chronic Achilles tendon rupture. Methods: A search was performed in the PubMed, Web of Science, Embase and Cochrane Database from 1960 to April 2017 to identify relevant articles. Predefined inclusion and exclusion criteria were applied to identify all eligible articles. Results: Total 186 articles were identified through our systematic search. Of these, 9 publications met the inclusion criteria. Five studies were case reports; three were case series; and one were expert opinion. Of a total 35 patients, 34 underwent Achilles tendon allograft repair and 1 peroneus brevis tendon allograft reconstruction. All patients experienced good clinical and functional results, but most reports used non-validated outcome measures. Conclusions: The evidence suggests that tendon allograft offers favorable outcomes in patients with chronic Achilles tendon rupture. However, randomized controlled trials which use validated functional outcome measures are required to determine effectiveness of this intervention. Level of evidence: Level V, systematic review of Level IV and V studies. (c) 2018 Published by Elsevier Ltd on behalf of European Foot and Ankle Society.