Insertional Achilles Tendinopathy Management: A Systematic Review

2010 ◽  
Vol 31 (8) ◽  
pp. 689-694 ◽  
Author(s):  
Rebecca Kearney ◽  
Matthew L. Costa
Keyword(s):  
Systematic Review ◽  
Achilles Tendinopathy ◽  
Insertional Achilles Tendinopathy

Surgical Takedown Approaches to Insertional Achilles Tendinopathy: A Systematic Review

2021 ◽  
Author(s):  
John Thompson ◽  
Kevin Nguyen ◽  
Jaime Ahluwalia ◽  
Dominick Casciato ◽  
Tyler Tewilliager ◽  
...  
Keyword(s):  
Systematic Review ◽  
Achilles Tendinopathy ◽  
Insertional Achilles Tendinopathy

Surgical Treatment of Insertional Achilles Tendinopathy: A Systematic Review

2020 ◽  
Vol 110 (5) ◽  
Author(s):  
Ruth Moen ◽  
Jacob R. Hagenbucher ◽  
Andrew B. Shinabarger
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Scoring Systems ◽  
Tendon Injury ◽  
Achilles Tendinopathy ◽  
Flexor Hallucis Longus ◽  
Inclusion Criteria ◽  
Gastrocnemius Recession ◽  
Tendon Autograft ◽  
Insertional Achilles Tendinopathy

Background Insertional Achilles tendinopathy is a common complaint among patients. Oftentimes, conservative treatment is inadequate, and surgical treatment is required. However, there is no published consensus regarding surgical intervention in reference to insertional Achilles tendinopathy. Methods The purpose of this systematic review was to evaluate the surgical management of insertional Achilles tendinopathy and report which surgical procedures provide the greatest pain reduction and improvement in functional outcome. A review of PubMed, OVID, Google Scholar, and Cochrane Controlled Trials Register was performed using a defined search strategy and inclusion criteria. Results Of 2,863 articles identified using the defined strategy, 20 met the inclusion criteria (three prospective and 17 retrospective). Operative interventions included Achilles tendon debridement, reattachment with suture anchors, reconstruction with flexor hallucis longus tendon autograft or bone-patellar tendon autograft, and gastrocnemius recession. All of the studies, regardless of intervention, showed generalized improvement after surgery. Wide variation in outcome scoring systems prevented direct comparison between studies and interventions. Conclusions This systematic review did not identify a superior treatment for insertional Achilles tendinopathy but rather found that the surgical treatment should be based on the extent of tendon injury.

Treatment for insertional Achilles tendinopathy: a systematic review

2012 ◽  
Vol 21 (6) ◽  
pp. 1345-1355 ◽  
Author(s):  
J. I. Wiegerinck ◽  
G. M. Kerkhoffs ◽  
M. N. van Sterkenburg ◽  
I. N. Sierevelt ◽  
C. N. van Dijk
Keyword(s):  
Systematic Review ◽  
Achilles Tendinopathy ◽  
Insertional Achilles Tendinopathy

scholarly journals Ultrasound and surgical inspection of plantaris tendon involvement in chronic painful insertional Achilles tendinopathy: a case series

2021 ◽  
Vol 7 (1) ◽  
pp. e000979
Author(s):  
Håkan Alfredson ◽  
Lorenzo Masci ◽  
Christoph Spang
Keyword(s):  
Achilles Tendon ◽  
Clinical Symptoms ◽  
Fatty Infiltration ◽  
Case Series ◽  
Achilles Tendinopathy ◽  
Level Of Evidence ◽  
Plantaris Tendon ◽  
Medial Pain ◽  
Tendon Insertion ◽  
Insertional Achilles Tendinopathy

ObjectivesChronic painful insertional Achilles tendinopathy is known to be difficult to manage. The diagnosis is not always easy because multiple different tissues can be involved. The plantaris tendon has recently been described to frequently be involved in chronic painful mid-portion Achilles tendinopathy. This study aimed to evaluate possible plantaris tendon involvement in patients with chronic painful insertional Achilles tendinopathy.MethodsNinety-nine consecutive patients (74 males, 25 females) with a mean age of 40 years (range 24–64) who were surgically treated for insertional Achilles tendinopathy, were included. Clinical examination, ultrasound (US)+Doppler examination, and surgical findings were used to evaluate plantaris tendon involvement.ResultsIn 48/99 patients, there were clinical symptoms of plantaris tendon involvement with pain and tenderness located medially at the Achilles tendon insertion. In all these cases, surgical findings showed a thick and wide plantaris tendon together with a richly vascularised fatty infiltration between the plantaris and Achilles tendon. US examination suspected plantaris involvement in 32/48 patients.ConclusionPlantaris tendon involvement can potentially be part of the pathology in chronic painful insertional Achilles tendinopathy and should be considered for diagnosis and treatment when there is distinct and focal medial pain and tenderness.Level of evidenceIV case series.

Evidence-based management of Achilles tendinopathy: A systematic review of physiotherapy interventions

Physiotherapy ◽  
2021 ◽  
Vol 113 ◽  
pp. e85-e86
Author(s):  
A.D. Gialeniou ◽  
A. Skoufas ◽  
G. Kaskaras ◽  
A. Karampougioukidis ◽  
K. Vassis
Keyword(s):  
Systematic Review ◽  
Achilles Tendinopathy ◽  
Evidence Based

scholarly journals Return to Sport in Athletes with Midportion Achilles Tendinopathy: A Qualitative Systematic Review Regarding Definitions and Criteria

2017 ◽  
Vol 48 (3) ◽  
pp. 705-723 ◽  
Author(s):  
Bas Habets ◽  
Anke G. van den Broek ◽  
Bionka M. A. Huisstede ◽  
Frank J. G. Backx ◽  
Robert E. H. van Cingel
Keyword(s):  
Systematic Review ◽  
Return To Sport ◽  
Achilles Tendinopathy ◽  
Qualitative Systematic Review

scholarly journals Up to a quarter of patients with certain chronic recalcitrant tendinopathies may have central sensitisation: a prospective cohort of more than 300 patients

2018 ◽  
Vol 13 (3) ◽  
pp. 137-144
Author(s):  
Patrick C Wheeler
Keyword(s):  
Lower Limb ◽  
Plantar Fasciitis ◽  
Pain Syndrome ◽  
Achilles Tendinopathy ◽  
Control Group ◽  
Greater Trochanteric Pain Syndrome ◽  
Duration Of Symptoms ◽  
Central Sensitisation ◽  
Clinical Records ◽  
Insertional Achilles Tendinopathy

Introduction: To identify the possible prevalence of ‘central sensitisation’, in patients with chronic recalcitrant lower limb tendinopathy conditions, with the Central Sensitisation Inventory (CSI) questionnaire. Methods: Patients with chronic lower limb tendinopathy conditions treated within a single hospital outpatient clinic specialising in tendinopathy were identified from clinical records. As part of routine care, self-reported numerical markers of pain, global function (using the EuroQol-5D (EQ-5D) questionnaire) and the CSI score to investigate the possibility of central sensitisation were completed. Results: A total of 312 suitable patients with chronic lower limb tendinopathy and similar conditions were identified, who had completed a CSI questionnaire. Of these, 108 presented with greater trochanteric pain syndrome, 12 with patella tendinopathy, 33 with non-insertional Achilles tendinopathy, 48 with insertional Achilles tendinopathy and 110 with plantar fasciitis. A total of 66% of the patients were female, the median age was 54.9 years and the median duration of symptoms was 24 months. There was a median CSI score of 25%, with statistically significant differences noted between the different conditions studied. Overall, 20% of patients scored above a threshold of 40% on CSI questionnaire, indicating that central sensitisation was possible. Greater trochanteric pain syndrome and plantar fasciitis had the highest proportions in the conditions studied. Weak correlations were found between CSI and other pain scores studied. Conclusion: The CSI questionnaire may identify up to a quarter of patients with some chronic lower limb tendinopathy and associated conditions as being more likely to have central sensitisation, and these proportions differed between conditions. The clinical significance of this is unclear, but worth further study to see if/how this may relate to treatment outcomes. These are results from a single hospital clinic dealing with patients with chronic tendinopathy, and comparison with a control group is currently lacking. However, on the information presented here, the concept of central sensitisation should be considered in patients being treated for chronic tendinopathy.

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