Operative treatment of chronic Achilles tendinopathy

Abstract

Seventy-six patients with Achilles tendinopathies (n=86) operated between 1980 and 1995 were retrospectively evaluated at an average follow-up of 13 (5-21) years. Total or gross partial ruptures were excluded. Patients' average age at surgery was 38 (18-58) years. The majority of patients were active in competitive or recreational sports. Tendinopathies were classified in peritendinitis, tendinosis, insertional tendinopathies, and mixed forms. The surgical technique depended entirely on the pathology encountered. For 32 cases of peritendinitis, results were excellent in 26, good in four, and poor in two. For eight cases of tendinosis, results were excellent in four and good in four. For 34 cases of insertional tendinopathy, results were excellent in 22, good in four, fair in four, and poor in four. For 12 cases of mixed tendinopathies, results were excellent in ten and good in two. Forty-nine patients (52 cases) were able to return to sport at the desired level.Résumé Soixante-seize malades avec une tendinopathie d'Achille (n=86) ont été opérés entre 1980 et 1995 et évalués rétrospectivement à un délai moyen de 13 (5-21) années. Les ruptures totales ou partielles importantes ont été exclues. L'âge moyen des malades à la chirurgie était 38 (18-58) années. La majorité des malades était des sportifs soit de loisir soit de compétition. Les tendinopathies ont été classés en: péritendinites, tendinites, tendinopathies d'insertion de et formes mixtes. La technique chirurgicale dépendait de la pathologie. Sur 32 pé-ritendinites, les résultats étaient excellents pour 26, bon pour quatre et mauvais pour deux . Sur huit tendinites, il y avait quatre excellents et 4 bons résultats. Sur 34 tendinopathies d'insertion, les résultats étaient excellents pour 22, bon pour quatre, juste pour quatre, et mauvais quatre. Sur 12 tendinopathies mixtes, les résultats étaient excellents pour dix et bon pour deux. Cinquante-deux malades étaient capables de revenir au sport au niveau désiré.

Current Concepts Review: Insertional Achilles Tendinopathy

“…Several studies have investigated open retrocalcaneal decompression and tendon debridement through a variety of approaches. 29,62,66,71 Watson et al compared the results of 16 cases of retrocalcaneal bursitis and 22 cases of bursitis with calcific insertional Achilles tendinopathy. Both groups were treated with an open retrocalcaneal decompression through a posterolateral approach and the latter group had a debridement of the Achilles with minimal detachment of the tendon.…”

Treatment of Chronic Achilles Tendinopathy and Ruptures with Flexor Hallucis Tendon Transfer: Clinical Outcome and MRI Findings

“…Once AT problems have become chronic, intra-and peritendinious scar formation, collagen degeneration, calcification and partial ruptures can be observed. 19,21,24,26,36,38,39 While different techniques of local debridement have shown good results in terms of pain relief, they fail to address elongation with thinning or even structural defects of the AT due to chronic rupture. In this situation, augmentation of the AT with a transfer of the flexor hallucis longus (FHL) muscle has been shown to give good pain relief and functional outcome.…”

Surgical Methods Of Management Of Haglund Deformity

“…A variety of measures, including (OHS/MFS/AOFAS) and others, were employed in seven studies to evaluate patients postoperatively and over time, while Chiara Vulpiani et al [13] developed their own.…”

“…Different scales were used in 7 studies for postoperative and follow up assessment such as (OHS/MFS/AOFAS) and others while Chiara Vulpiani et al, (13) used their own scale.…”