Failed Tendoachilles Repair Salvage

Revision Surgery

Salvaging a Failed Tendoachilles Repair

A seven-surgery salvage of a chronic, infected Achilles failure — reconstructed with a peroneus longus transfer after the tendon and its first replacement were lost.

Patient Age

Adult

MECHANISM

Chronic heel pain (2 yrs)

PRESENTATION

2 Years of Pain, Multiple Failed Surgeries

APPROACH

Debridement, FHL Transfer, Peroneus Longus Transfer

01 Clinical Rationale

Deep infection at a previous recession site cost this patient both the Achilles tendon and its first replacement. Function was ultimately restored by transferring peroneus longus to the heel — a salvage route taken only after every reconstruction option had failed.

02 Surgical Approach

Treated in staged revisions: debridement, mid-segment Achilles excision with FHL transfer, then total excision of the tendoachilles and FHL once infection persisted. Function was finally restored by transferring peroneus longus to the heel, fixed with a bio screw and later revised with anchorage to the calcaneus.

02 Imaging & Progression

Pre-operative imaging, intra-operative views and post-operative results across the revision stages. Each slot maps to a CMS image field — drop in the matching consented file from the case folder.

#1

Carefully performed tendoachilles surgery must avoid damaging the sural nerve, the commonest source of lasting pain.

#2

Deep infection at a recession site demands aggressive debridement before any reconstruction is attempted.

#3

When the tendon and its first replacement are lost, a peroneus longus transfer to the heel restores push-off.

#4

Secure fixation matters — an early fall can dislodge a bio screw, requiring revision with a larger screw and heel anchorage.

04 Clinical Care Points

RIGHT SIDE

LEFT SIDE

| 35+ YEARS OF TRUST, CARE & EXCELLENCE

Salvaging a Failed Tendoachilles Repair

A seven-surgery salvage of a chronic, infected Achilles failure — reconstructed with a peroneus longus transfer after the tendon and its first replacement were lost.

The patient had undergone several operations for persistent heel and calf problems beginning with plantar-fascia release and gastrocnemius recession. A postoperative calf infection led to repeated debridement, followed by excision of the diseased Achilles segment and an FHL tendon transfer, but low-grade infection continued and both tendons ultimately had to be removed. A peroneus-longus transfer was then used to reconstruct the Achilles mechanism, only for an early fall to pull the tendon out and extrude the fixation screw.