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Results of operative treatment for recalcitrant retrocalcaneal bursitis and midportion Achilles tendinopathy in athletes

  • Orthopaedic Surgery
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The results of operative treatment for recalcitrant midportion Achilles tendinopathy and recalcitrant retrocalcaneal bursitis were evaluated using the patient administered, disease specific, and validated VISA-A-G questionnaire.


A cohort of 89 patients was prospectively followed. These patients underwent operations for sport induced midportion Achilles tendinopathy (39 procedures) or retrocalcaneal bursitis (55 procedures). Depending on the individual intraoperative findings the patients of either disease were treated with two respective operative modifications (tendon repair or no tendon repair). Preoperative and follow-up status (3, 6, and 12 months) were investigated using the VISA-A-G questionnaire.


Preoperatively, the four groups scored from 37.0 ± 17.6 to 45.9 ± 15.2 (p = 0.376–0.993) on the VISA-A-G questionnaire. Six and 12 months postoperatively, the VISA-A-G scores improved significantly (p < 0.001). Twelve months postoperatively, the groups’ scores were not different (p = 0.100–0.952) and ranged from 80.8 ± 17.9 to 90.3 ± 10.6.


Retrocalcaneal bursitis and midportion Achilles tendinopathy responded equally well to operative treatment. When repaired, additional tendon lesions did not influence this result. We demand to differentiate not only between midportion Achilles tendinopathy and retrocalcaneal bursitis but also to identify additional Achilles tendon lesions to specifically address these lesions during operative procedures.

Level of evidence

Prospective mixed cohort study.

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The authors gratefully acknowledge the contribution of Dr. Ackermann, Department of Medical Statistics, University Frankfurt/Main for his expert advice and statistical support. The Hessian Ministry for Interior and Sports supported the study. This sponsor was not involved in the discharge or organization of the study.

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Correspondence to Heinz Lohrer.

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Lohrer, H., Nauck, T. Results of operative treatment for recalcitrant retrocalcaneal bursitis and midportion Achilles tendinopathy in athletes. Arch Orthop Trauma Surg 134, 1073–1081 (2014).

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