Safety of Achilles Detachment and Reattachment Using a Standard Midline Approach to Insertional Enthesophytes

McAlister, Jeffrey E.; Hyer, Christopher F.

doi:10.1053/j.jfas.2014.12.009

Cited by 40 publications

(23 citation statements)

References 19 publications

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“…However, one of the drawbacks of the CA is that it results in substantial tension over the wound after closure and, therefore, may cause delayed wound healing and wound dehiscence, as were commonly reported in previous studies. (15,20,21,25,26) Similarly, we observed in our study that the CA led to significantly more cases of delayed wound healing when compared with the LA.…”

Section: Discussionsupporting

confidence: 82%

Lateral versus central tendon-splitting approach to insertional Achilles tendinopathy: a retrospective study

Xia¹,

Yew²,

Zhang³

et al. 2019

smedj

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This study aimed to compare operative outcomes between the lateral approach (LA) and the central approach (CA) to insertional Achilles tendinopathy (IAT). METHODS We retrospectively reviewed patients who underwent surgical treatment for IAT using the LA or CA. Patients' demographic data, postoperative complications and satisfaction rate were reviewed. Clinical outcomes were prospectively assessed preoperatively, at three months postoperatively and at the last visit, including patients' visual analogue scale (VAS) scores for pain, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale scores and 36-item Short Form Health Survey (SF-36) scores. RESULTS There were 39 patients in the LA group and 32 in the CA group. In each group, average VAS and AOFAS Scale scores improved significantly. SF-36 scores improved in most parameters. No significant difference in baseline score; average AOFAS Scale score at each visit; and mean VAS score preoperatively and at last visit; satisfaction rate; and overall complication rate were observed between the groups. The mean VAS score in the LA group at postoperative three months was significantly lower than that in the CA group (2.7 ± 2.5 vs. 4.4 ± 3.0; p = 0.016). There were significantly more cases of delayed wound healing in the LA group than in the CA group (2.6% vs. 15.6%; p = 0.049). CONCLUSION Both approaches had comparable outcomes for IAT in terms of functional improvement, pain relief, overall enhancement of patients' health condition and overall postoperative complication rate. The LA provided better short-term pain relief and reduced delayed wound healing compared with the CA.

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Section: Discussionsupporting

confidence: 82%

Lateral versus central tendon-splitting approach to insertional Achilles tendinopathy: a retrospective study

Xia¹,

Yew²,

Zhang³

et al. 2019

smedj

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“…Open detachment with reattachment of the Achilles tendon is a common surgery combined with calcaneoplasty and debridement of the retrocalcaneal bursitis and pathologic Achilles tendon. 18 Suture techniques using bone anchors have been described to reattach the Achilles tendon with excellent results. 22 Although the Achilles is reattached into its footprint on the calcaneus, avoiding detachment of the tendon altogether is usually preferred.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Achilles Tendon Augmentation With Suture Anchors After Calcaneal Exostectomy in Haglund Syndrome

et al. 2018

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“…Despite the large number of studies reporting on the outcome of surgically treated IAT, the authors are not aware of any study focusing on factors influencing the occurrence of complication. 7,9,24,27,28,32 This is most likely due to the combination of smaller patient cohorts and the low number of complications.…”

Section: Discussionmentioning

confidence: 99%

Complications Associated With Midline Incision for Insertional Achilles Tendinopathy

Hörterer¹,

Baumbach²,

Oppelt³

et al. 2020

Foot Ankle Int.

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Background: The midline-incision trans-achillary approach (MITA) is frequently used for addressing all pathologies of insertional Achilles tendinopathy (IAT). The aim of this study was to assess the complication rate and possible influencing factors following a MITA for IAT treatment. Methods: Presented is a retrospective cohort study with current follow-up. Patients treated surgically by a MITA, addressing all pathologies of IAT, between January 2010 and October 2016 at a single reference center with at least 12 months of follow-up were included. General demographics (age, sex, and body mass index), medical history, surgical details (individual and sum of pathologies addressed), and duration of in-hospital stay were assessed. Patient satisfaction, shoe conflict, current employment status, time to return to sports, and type of sports were recorded using a custom questionnaire. Standard statistics, chi-square, and t tests were performed using SPSS. A total of 118 patients (follow-up, 63.4%) with a mean age (± SD) of 50 ± 12 years and a mean final follow-up time (± SD) of 4.2 ± 2.1 were included. Results: Fourteen percent of patients had a minor complication, the majority (75%) of which were surgical site infections. Forty-one percent were limited in their shoe selection, and 32% reported a shoe conflict. Seventy-eight percent were very satisfied, and 89% would recommend the surgery. Neither the individual surgical procedures, their sum, nor any other parameter showed a significant influence on the complication rate. The only factor negatively affecting patient satisfaction was a shoe conflict ( P < .001). Conclusion: The MITA for IAT treatment showed a moderate minor complication rate with good midterm patient satisfaction. However, the approach might predispose patients to shoe conflict, which negatively influences their satisfaction. Level of Evidence: Level IV, retrospective cohort study.

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Safety of Achilles Detachment and Reattachment Using a Standard Midline Approach to Insertional Enthesophytes

Cited by 40 publications

References 19 publications

Lateral versus central tendon-splitting approach to insertional Achilles tendinopathy: a retrospective study

Lateral versus central tendon-splitting approach to insertional Achilles tendinopathy: a retrospective study

Endoscopic Achilles Tendon Augmentation With Suture Anchors After Calcaneal Exostectomy in Haglund Syndrome

Complications Associated With Midline Incision for Insertional Achilles Tendinopathy

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