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Endoscopic peroneus brevis tendon transfer for chronic ruptures of the Achilles tendon: surgical technique

Poeta, Nicola; Maffulli, Nicola; Bucolo, Fabrizio; Charpail, Christel; Migliorini, Filippo; Guillo, Stéphane


Nicola Poeta

Nicola Maffulli

Fabrizio Bucolo

Christel Charpail

Filippo Migliorini

Stéphane Guillo


Chronic Achilles tendon rupture is usually defined as a rupture diagnosed 4–6 weeks after injury. The management of chronic Achilles tendon rupture (CATR) is a topic of hot debate, and no consensus has been achieved. Surgical management of CATR is recommended. Several approaches, techniques, and grafts have been described. Open techniques carry a high risk of wound breakdown, infection, and necessitate long rehabilitation times. Surgical techniques with smaller incisions to reduce the risk of scar fibrosis, pain, and infection are becoming common. The ipsilateral tendon of the hallux flexor longus and the peroneus brevis is commonly used. Endoscopic transfer of the peroneus brevis tendon is an innovative alternative to other procedures, with comparable results of other autografts even in elite athletes. The tendon of the peroneus brevis is harvested by tendoscopy before performing a calcaneal tendon endoscopy and fixing the graft in a calcaneal tunnel using an interference screw. After surgery, an anterior splint is placed for 3 weeks with immediate forefoot weight bearing. The rehabilitation starts on the 15th postoperative day.


Poeta, N., Maffulli, N., Bucolo, F., Charpail, C., Migliorini, F., & Guillo, S. (in press). Endoscopic peroneus brevis tendon transfer for chronic ruptures of the Achilles tendon: surgical technique. Journal of Orthopaedic Surgery and Research, 19(1), Article 131.

Journal Article Type Article
Acceptance Date Jan 3, 2024
Online Publication Date Feb 10, 2024
Deposit Date Feb 19, 2024
Journal Journal of Orthopaedic Surgery and Research
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 19
Issue 1
Article Number 131
Keywords Peroneus brevis transfer, Endoscopic surgery, Chronic Achilles tendon rupture
Publisher URL