Achilles tendoscopy for non insertional Achilles tendinopathy. A case series study.

BACKGROUND

Achilles non-insertional tendinopathy is usually treated with conservative means. If resistant to a rehabilitation protocol surgical treatment could be proposed. The aim of this research is to report the mid-term clinical results of endoscopic assisted surgery for patients suffering from recalcitrant painful non-insertional Achilles tendinopathy.

METHODS

A consecutive series of 11 patients (6 men and 5 women), median age of 54 (range 40-67) years, with chronic recalcitrant painful non-insertional Achilles tendinopathy were included. All patients completed at least 20 physical therapy sessions and 6 months of no sports activities before surgery. All underwent Achilles tendoscopy, without tendon excision or transfer with a median follow-up of 87 (27-105) months. We report the preoperative symptoms duration, treatment before surgery, complications and satisfaction after surgery, return to previous sport level, and postoperative VISA-A score.

RESULTS

Mean preoperative symptoms duration was 1 year, having all performed at least 20 physical therapy sessions. No postoperative complications were reported, achieving a complete satisfaction in 10 of 11 patients. All patients returned to their preoperative sports level with a median postoperative VISA-A functional score of 100 (30-100) points.

CONCLUSIONS

The mid-term results of Achilles tendoscopy in patients with chronic painful non-insertional Achilles tendinopathy are satisfactory with a rapid rehabilitation. This procedure is safe and has a low complication rate.

LEVEL OF EVIDENCE: IV. Retrospective case series.