Dual semitendinosus allograft reconstruction of large achilles tendon defects

Patients with chronic midsubstance Achilles tendinopathy who do not respond to nonoperative management often require surgical intervention. Debridement of the diseased and dysfunctional tendon may result in a gap >5 cm. A number of previously described techniques to bridge the defect include V-Y lengthening, turndown procedures, local tendon transfers, synthetic grafts, and hamstring autograft and allograft. This article describes a novel technique using 2 semitendinosus allografts to reconstruct Achilles tendinopathy with large defects. There are 2 options for distal fixation depending upon the residual amount of Achilles tendon that remains distally on the heel. This technique offers another option for the surgeon in the face of a difficult reconstructive procedure. Early outcomes have been excellent.