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Results of minimally invasive Achilles tendon scraping and plantaris tendon removal in patients with chronic midportion Achilles tendinopathy: A longer-term follow-up study
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). Dr. Alfen Orthopaedic Spine Center, Würzburg, Germany.ORCID iD: 0000-0002-9977-334X
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine. Institute of Sport, Exercise and Health (ISEH), University College London Hospitals (UCLH), London, UK; Pure Sports Medicine Clinic, London, UK.
2019 (English)In: Safety, ISSN 0036-3375, E-ISSN 2050-3121, Vol. 7, article id UNSP 2050312118822642Article in journal (Refereed) Published
Abstract [en]

Background: Treatment with ultrasound and colour Doppler–guided minimally invasive Achilles tendon scraping and plantaris tendon removal has shown promising short-term results in patients with chronic painful midportion Achilles tendinopathy.

Methods: In a follow-up study, 182 consecutive patients (241 tendons) who had undergone Achilles tendon scraping and plantaris tendon removal were contacted on telephone by an independent investigator. The patients who answered the telephone call were included, and they answered a questionnaire on telephone and then also sent their written answers. The questionnaire included information about patient satisfaction with the result of the treatment, time to return to full Achilles tendon loading activity, and a pain score (Visual Analogue Scale-VAS).

Results: The follow-up period was 5.8 years (mean) (range of 2–13 years) after surgery. Altogether, 110 patients (136 Achilles tendons), 52 years (mean)(range 18-73) old at surgery could be reached and were included. In total, 81 tendons were operated with the Achilles scraping procedure alone, and for 55 Achilles operations also a plantaris tendon removal was performed. For 93% of the operated tendons, the patients were satisfied with the surgical outcome and the VAS had decreased from 74 preoperatively to 8 postoperatively. Nine male patients (9 tendons), five operated with scraping + plantaris removal, had remaining tendon pain during loading and were not satisfied. Their VAS score ranged from 22 to 91. For 21% of the operated tendons, some occasional mild discomfort not preventing from full tendon loading, was reported. There were no differences in pain reduction and satisfaction rates between men and women, and between Achilles scraping alone and scraping plus plantaris removal.

Conclusion: Ultrasound and colour Doppler–guided surgical Achilles tendon scraping and plantaris tendon removal in patients with chronic painful midportion Achilles tendinopathy show remaining good clinical outcomes and high satisfaction rates in this longer-term follow-up.

Place, publisher, year, edition, pages
Sage Publications, 2019. Vol. 7, article id UNSP 2050312118822642
Keywords [en]
Achilles tendinopathy, surgery, scraping, plantaris tendon, longer-term results
National Category
Sport and Fitness Sciences
Identifiers
URN: urn:nbn:se:umu:diva-156595DOI: 10.1177/2050312118822642ISI: 000457396600001PubMedID: 30728966OAI: oai:DiVA.org:umu-156595DiVA, id: diva2:1290460
Available from: 2019-02-20 Created: 2019-02-20 Last updated: 2019-02-20Bibliographically approved

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Spang, ChristophAlfredson, Håkan

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