TOTBİD Dergisi

TOTBİD Dergisi

2018, Cilt 17, Sayı, 1     (Sayfalar: 051-056)

Surgical options in Achilles tendinopathies

Tekin Kerem Ülkü 1, Barış Kocaoğlu 1

1 Acıbadem Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, İstanbul

DOI: 10.14292/totbid.dergisi.2018.06
Görüntüleme: 898
İndirme : 851

Despite its high endurance and elasticity Achilles tendon together with patellar tendon are the two tendons mostly affected from overuse. Tendinopathies can be seen both in sports participating population and in sedentary population. Achilles body tendinitis is defined as nodular swelling, pain and impairment in tendon function in 2-7 cm proximal from tendon insertion. Achilles paratendinopathy is generally seen together with hyperemia and increased heat over the tendon. Also pain over the calcaneal insertion of the Achilles tendon is referred as insertional Achilles tendinopathy. Primary treatment modality in Achilles tendinopathies is conservative. There are studies showing the success of eccentric stretching exercises and ESWT (Extracorporeal Shock Wave Therapy). However, some studies showed 24–45% failure in conservative treatment. Long lasting Achilles tendinopathies are associated with inferior clinical outcomes. Surgical treatment should be considered in tendinopathies lasting more than 6 months. Surgical treatment of Achilles body tendinopathies consists of open, percutaneous, and endoscopic techniques. Endoscopic techniques involving debridement and plantaris release are gaining popularity. For insertional tendinopathies efficient debridement is very important for successful outcomes, however it needs near complete detachment of tendon from calcaneus. Reattachment using at least two anchors is shown to be effective, however double row repair is gaining popularity.

Anahtar Kelimeler : Achilles; tendinopathy; Haglund; surgery