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BACKGROUND
In cases of tibialis anterior tendon (TAT) ruptures associated with
significant tendon defect, an interposition graft is often needed
for reconstruction. Both auto- and allograft reconstructions have
been described in the literature. Our hypothesis was that both graft
types would have a good integrity and provide comparable
outcomes.
METHODS
Patients who underwent TAT reconstruction using either an auto- or
allograft were identified. Patient-reported outcomes (PROs) were
collected using the 12-Item Short Form Health Survey (SF-12)
questionnaire, the American Orthopaedic Foot & Ankle Society
(AOFAS) hindfoot score, the Foot Function Index (FFI), and the
Karlsson-Peterson score. Functional outcome was assessed by
isokinetic strength measurement. Outcomes were further assessed with
magnetic resonance imaging (MRI) evaluation of graft integrity. All
measurements were also performed for the contralateral foot.
RESULTS
Twenty-one patients with an average follow-up of 82 months (20-262
months), comprising 12 allograft and 9 autograft TAT
reconstructions, were recruited. There were no significant
differences in patient-reported outcomes between allograft
reconstructions and autografts: SF-12 (30.7 vs 31.1, = .77); AOFAS
(83 vs 91.2, = .19); FFI (20.7% vs 9.5%, = .22); and
Karlsson-Peterson (78.9 vs 87.1, = .23). All grafts (100%) were
intact on MRI with a well-preserved integrity and no signs of new
rupture. There were no major differences in range of motion and
functional outcomes as measured by strength testing between the
operative and nonoperative side.
CONCLUSION
Reconstructions of TAT achieved good PROs, as well as functional and
imaging results with a preserved graft integrity in all cases. There
were no substantial differences between allograft and autograft
reconstructions.
LEVEL OF EVIDENCE
Level IV, retrospective case series.
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