Treatment of Achilles tendinopathy: state of the art

Ackermann, Paul W.; Phisitkul, Phinit; Pearce, Christopher J.

doi:10.1136/jisakos-2018-000202

Cited by 5 publications

(2 citation statements)

References 94 publications

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“…Initial conservative approaches, emphasizing rest and immobilization, have gradually given way to more aggressive surgical interventions as understanding of tendon healing and biomechanics has deepened [7,8]. Among the various surgical techniques, Baker's procedure, involving the lengthening of the gastrocnemius-soleus complex, has been noted for its effectiveness in managing chronic Achilles tendon issues [9][10][11]. In the realm of Achilles tendon injury management, a significant gap in the literature pertains to understanding the complications associated with Baker's procedure, particularly in the context of neglected injuries.…”

Section: Introductionmentioning

confidence: 99%

Incidents of Complications after Reconstruction of Neglected Achilles Tendon Injury by Baker's Procedure

Hossain,

Shahiduzzaman,

Hossain

et al. 2024

EAS J Orthop Physiother

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Introduction: Neglected Achilles tendon ruptures present a significant challenge in orthopedic surgery, with varied outcomes and complications. This study aims to evaluate the effectiveness of Baker's Procedure in the reconstruction of neglected Achilles tendon ruptures and to analyze the associated postoperative outcomes and complications. Methods: This prospective interventional study was conducted from January 1, 2012, to May 31, 2013, at multiple centers in Dhaka, Bangladesh. It included 42 patients aged 18 to 60 years with neglected Tendo-Achilles ruptures, defined as injuries untreated for over 4 weeks. Baker's Procedure, involving gastrocnemius aponeurosis advancement, was employed for reconstruction. Result: Of the 42 participants, 71.43% were male, with a mean age of 30.7 years. Injuries predominantly occurred in the right Achilles tendon (57.14%) and were mainly caused by sharp-metal objects (57.14%) and toilet-pan accidents (35.71%). Postoperative complications included stitch or wound infections (21.43%), pain (14.29%), stiffness (28.57%), and calf-muscle weakness (35.71%). Excellent, good, and fair outcomes were achieved in 64.29%, 21.43%, and 14.29% of patients, respectively. Conclusion: Baker’s Procedure is effective in reconstructing neglected Achilles tendon ruptures, with a majority of patients achieving excellent or good outcomes. However, the relatively high rate of postoperative complications, particularly infections, calf muscle weakness and stiffness, highlights the need for improved surgical and postoperative strategies. These findings underscore the importance of tailored.

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Section: Introductionmentioning

confidence: 99%

Incidents of Complications after Reconstruction of Neglected Achilles Tendon Injury by Baker's Procedure

Hossain,

Shahiduzzaman,

Hossain

et al. 2024

EAS J Orthop Physiother

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“…Current conservative treatment strategies involve the topical or oral application of nonsteroidal anti-inflammatory drugs (NSAIDs), loading exercises (ie, eccentric-concentric loading), cooling, taping, and exercise rehabilitation. Nonsurgical therapies are also used, including acupuncture, focused shock wave treatment, and electrotherapies (ie, different forms of transcutaneous electrical nerve stimulation [TENS]) [ 11 - 13 ]. In cases of long-standing symptoms that cannot be managed conservatively, surgical splitting of the tendon lengthwise and excision of necrotic tissue can be attempted [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Bioelectric Current Stimulation in the Treatment of Chronic Achilles Tendinopathy: Protocol for a Double-Blind, Placebo-Controlled Randomized Multicenter Trial

Schröder

Molsberger

Drabik³

et al. 2022

JMIR Res Protoc

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Background The consensus for the optimal treatment strategy for chronic Achilles tendinopathy (AT) is still debated and treatment options are limited. This results in a significant medical need for more effective treatment options. Objective The aim of this study is to investigate the therapeutic effects of percutaneous bioelectric current stimulation (PBCS) on AT. Methods A multicenter, randomized, double-blind, placebo-controlled clinical trial will be conducted. A total of 72 participants with chronic (ie, >3 months) midpoint AT will be randomized and receive four PBCS sessions—either verum or placebo—over 3 weeks. Both groups will complete daily Achilles tendon loading exercises in addition to the intervention. Evaluation sessions will be completed at baseline and during the intervention (weeks 0-3). Self-reported outcome measures will be completed at follow-up at weeks 4, 12, 26, and 52. The primary outcomes are the Victorian Institute of Sports Assessment–Achilles questionnaire scores and statistical evaluation of intraindividual differences between baseline and 12-week evaluations after initial treatment of verum therapy compared to control. Secondary outcomes will assess Pain Disability Index scores; average pain, using the 11-point Numeric Rating Scale; return to sports; and use of emergency medication. Results The study began in May 2021. As of October 2022, we randomized 66 out of 72 participants. We anticipate completing recruitment by the end of 2022 and completing primary data analysis by March 2023. Conclusions The study will evaluate the effects of PBCS on pain, physical function, and clinical outcomes. Trial Registration German Clinical Trials Register DRKS00017293; https://tinyurl.com/mvz7s98k International Registered Report Identifier (IRRID) DERR1-10.2196/40894

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Short-term Effects of Pulsed Electromagnetic Field Therapy for Achilles Tendinopathy: A Randomized Controlled Trial

Ko,

Chen,

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: Pulsed electromagnetic field (PEMF) therapy is a potential nonoperative treatment for Achilles tendinopathy, but the current published literature on its effects is sparse. Purpose: To evaluate the therapeutic efficacy of PEMF therapy and eccentric exercise for Achilles tendinopathy. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 65 participants met the inclusion criteria and were randomly assigned to either the active PEMF group (n = 33) or the sham group (n = 32). The PEMF group received biweekly PEMF therapy (10 minutes per session) for 8 weeks, plus eccentric exercise for 12 weeks. The sham group received the same eccentric exercise for 12 weeks minus active PEMF exposure. The primary outcome was the Victorian Institute of Sports Assessment–Achilles (VISA-A) questionnaire. The secondary outcomes were numeric pain rating scale (NPRS) score, tendon neovascularity, and total time spent on sports per week. A physical therapist assessed all outcomes at baseline and then 4, 8, and 12 weeks after the commencement of the PEMF treatment. The level of tendon neovascularity was determined by the Öhberg score (range, 0-3). Results: VISA-A scores improved significantly from baseline to 12 weeks posttreatment in both the PEMF group (from 57.9 to 71.7) and the sham group (from 55.1 to 66.8) ( P < .001 for both), with no significant difference in scores between treatment groups throughout the 12 weeks ( P = .527). NPRS scores during sports also improved significantly from baseline to 12 weeks for the PEMF group (from 6.05 to 2.95) and the sham group (from 6.45 to 3.85) ( P < .001), with no group differences ( P = .346). Conclusion: PEMF therapy, in addition to eccentric exercise, did not improve outcome scores or tendon neovascularity compared with eccentric exercise alone in participants with Achilles tendinopathy. Registration: NCT05316961 (ClinicalTrials.gov identifier).

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Treatment of Achilles tendinopathy: state of the art

Cited by 5 publications

References 94 publications

Incidents of Complications after Reconstruction of Neglected Achilles Tendon Injury by Baker's Procedure

Incidents of Complications after Reconstruction of Neglected Achilles Tendon Injury by Baker's Procedure

Percutaneous Bioelectric Current Stimulation in the Treatment of Chronic Achilles Tendinopathy: Protocol for a Double-Blind, Placebo-Controlled Randomized Multicenter Trial

Short-term Effects of Pulsed Electromagnetic Field Therapy for Achilles Tendinopathy: A Randomized Controlled Trial

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