Insertional Achilles Tendinopathy: Analysis of 166 Procedures and Return to Activity.

Abstract

The surgical procedure for Insertional Achilles tendinopathy (IAT) varies widely with no consensus as to approach and documenting return to activity (RTA). This study presents outcomes of surgery for IAT by a single surgeon, documenting activity level and return to activity. From January 2001 through January 2018, 166 procedures were reviewed. Surgery included debridement of the Achilles insertion, resection of the superior calcaneus and bursa, and re-attachment with suture anchors. There were 110 males and 56 females. The majority of patients in the entire cohort were runners (n = 54). The average age of the cohort was 50.3 ± 12.1 years (range 20-80). Average follow-up was 114.0 ± 63.5 months (range 6-222 months). Average RTA for males and females were 6.43 months and 7.22 months, (p = .2), respectively. There was no difference in RTA between patients who had calcific tendinosis (n = 84) and noncalcific tendinosis (n = 82). Complications were 2 infections, 2 DVTs, and 17 deep suture reactions with a total complication rate of 12.6%; there were no re-ruptures postoperatively. There was no significant difference in number of complications between absorbable and nonabsorbable suture in the anchors (p = .41). The average RM score was 1.5 ± 0.7. The RM scores were better for males (p = .002), but there were no differences in RTA or complications between sexes. Overall, 95.8% of the procedures resulted in improved outcome and ability to return to activity including sports. This retrospective investigation shows surgical intervention for IAT yields good results with an average return to activity including sports in approximately 7 months.

• Authors: Amol Saxena, Nicola Maffulli, Anqi Jin, Eghosa Isa, William Philip Arthur, Alanna Wahl
• Journal: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons (J Foot Ankle Surg) 2021 Nov-Dec Vol. 60 Issue 6 Pg. 1117-1123 ISSN: 1542-2224 [Electronic] United States
• PMID: 34024676 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Achilles Tendon (surgery)
• Adult
• Aged
• Aged, 80 and over
• Calcaneus
• Female
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Suture Anchors
• Tendinopathy (surgery)
• Young Adult