Surgery for Chronic Achilles Tendinopathy Yields Worse Results in Nonathletic Patients

Maffulli, Nicola; Testa, Vittorino; Capasso, Giovanni; Oliva, Francesco; Sullo, A.; Benazzo, Francesco; Regine, R.; King, John B.

doi:10.1097/00042752-200603000-00007

Cited by 75 publications

(51 citation statements)

References 25 publications

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“…31 Ultrasound is an effective imaging method because it correlates well with the histopathologic findings despite being operator-dependent. 32 MRI studies should be performed only if the ultrasound scan remains unclear.…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Chronic Achilles Tendon Disorders

Maffulli¹,

Via²,

Oliva³

2015

Clinics in Sports Medicine

Self Cite

101

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Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Chronic Achilles Tendon Disorders

Maffulli¹,

Via²,

Oliva³

2015

Clinics in Sports Medicine

Self Cite

101

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“…Many studies evaluate various forms of surgery to treat Achilles tendinopathy [92,102,109,122,139,151,191]. The approaches vary greatly between studies based partly on the extent of abnormality.…”

Section: Surgerymentioning

confidence: 99%

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

Andres

Murrell

2008

Clinical Orthopaedics &Amp; Related Research

454

345

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Tendinopathy is a broad term encompassing painful conditions occurring in and around tendons in response to overuse. Recent basic science research suggests little or no inflammation is present in these conditions. Thus, traditional treatment modalities aimed at controlling inflammation such as corticosteroid injections and nonsteroidal antiinflammatory medications (NSAIDS) may not be the most effective options. We performed a systematic review of the literature to determine the best treatment options for tendinopathy. We evaluated the effectiveness of NSAIDS, corticosteroid injections, exercise-based physical therapy, physical therapy modalities, shock wave therapy, sclerotherapy, nitric oxide patches, surgery, growth factors, and stem cell treatment. NSAIDS and corticosteroids appear to provide pain relief in the short term, but their effectiveness in the long term has not been demonstrated. We identified inconsistent results with shock wave therapy and physical therapy modalities such as ultrasound, iontophoresis and low-level laser therapy. Current data support the use of eccentric strengthening protocols, sclerotherapy, and nitric oxide patches, but larger, multicenter trials are needed to confirm the early results with these treatments. Preliminary work with growth factors and stem cells is promising, but further study is required in these fields. Surgery remains the last option due to the morbidity and inconsistent outcomes. The ideal treatment for tendinopathy remains unclear.

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“…5,111 Long-term follow-up ranging between 2 and 8 years suggests that between 71% to 100% of patients with Achilles tendinopathy are able to return to their prior level of activity with minimal or no complaints. 3,97,98 Interestingly, the results of both conservative 114 and operative care 74 are less favorable in nonathletic populations.…”

Section: Prognosismentioning

confidence: 99%

Achilles Pain, Stiffness, and Muscle Power Deficits: Achilles Tendinitis

Carcia

Martin²,

Houck³

et al. 2010

Journal of Orthopaedic & Sports Physical Therapy

119

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The Orthopaedic Section of the American Physical Therapy Association presents this sixth set of clinical practice guidelines on Achilles pain, stiffness, and muscle power deficits that are characteristic of Achilles Tendinitis. These clinical practice guidelines are linked to the International Classification of Functioning, Disability, and Health (ICF). The purpose of these practice guidelines is to describe evidence-based orthopaedic physical therapy clinical practice and provide recommendations for (1) examination and diagnostic classification based on body functions and body structures, activity limitations, and participation restrictions, (2) interventions provided by physical therapists, (3) and assessment of outcome for common musculoskeletal disorders. J Orthop Sports Phys Ther 2010:40(9):A1–A26. doi:10.2519/jospt.2010.0305

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Surgery for Chronic Achilles Tendinopathy Yields Worse Results in Nonathletic Patients

Abstract: Nonathletic subjects experience more prolonged recovery, more complications, and a greater risk of further surgery than athletic subjects with recalcitrant Achilles tendinopathy.

Cited by 75 publications

References 25 publications

Chronic Achilles Tendon Disorders

Chronic Achilles Tendon Disorders

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

Achilles Pain, Stiffness, and Muscle Power Deficits: Achilles Tendinitis

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