Advertisement

Operative Treatment of Tendinopathies of Achilles Tendon

  • Sakari OravaEmail author
  • Lasse Lempainen
  • Janne Sarimo
Chapter

Abstract

Achilles tendon tendinopathies form a special group of disorders, which usually affect athletes or physically active individuals as overuse injuries from hard training and performances in sports. There are congenital reasons leading to Achilles complaints, and sometimes overuse injuries occur to normal people, too. Tendinopathies can be divided to non-insertional or mid-tendon problems and insertional, retro calcaneal problems. Inside these main groups there are different clinical entities, which can be differentiated with radiological examination or by histological specimens. In chronic cases, when active sports is difficult, painful, or not possible at all, surgical treatment is needed. Several surgical techniques are available. In this review, surgical methods used in different tendinopathies are presented.

Keywords

Achilles tendon Tendinopathies Differential diagnosis Surgery 

References

  1. 1.
    Galloway M, Jokl P, Dayton W. Achilles tendon overuse injuries. Clin Sports Med. 1992;11:771–82.PubMedGoogle Scholar
  2. 2.
    Kannus P. Etiology and pathophysiology of chronic tendon disorders in sports. Scand J Med Sci Sports. 1997;7:72–7.Google Scholar
  3. 3.
    Leppilahti J, Orava S, Karpakka J, Takala T. Overuse injuries of the Achilles tendon. Ann Chir Gynaecol. 1991;80:202–7.PubMedGoogle Scholar
  4. 4.
    Clement D, Facsm M, Taunton J, Facsm MD, Smart W. Achilles tendinitis and peritendinitis: etiology and treatment. Am J Sports Med. 1984;12:179–84.CrossRefGoogle Scholar
  5. 5.
    Kvist M. Achilles tendon injuries in athletes. Sports Med. 1994;18:173–201.CrossRefGoogle Scholar
  6. 6.
    Orava S, Leppilahti J. Surgical treatment of Achilles tendon alignments. In: Chan KM, Fu F, Maffulli N, Rolf C, Kurosaka M, Liu S, editors. Controversies in orthopedic sports medicine. Hong Kong: Williams and Wilkins; 1998. p. 519–30.Google Scholar
  7. 7.
    Cohrer H, Nauck T. Results of operative treatment for recalcitrant retrocalcaneal bursitis and mid-portion Achilles tendinopathy. Arch Orthop Trauma Surg. 2014;134:1073–81.CrossRefGoogle Scholar
  8. 8.
    Leppilahti J, Karpakka J, Gorra A, Orava S. Surgical treatment of overuse injuries to the Achilles tendon. Clin J Sports Med. 1994;4:100–7.CrossRefGoogle Scholar
  9. 9.
    Kvist M. Achilles tendon overuse injuries in athletes. A clinical and pathophysiological study with special reference to Achilles paratenonitis. Doctoral Thesis. Annales Univ Turkuensis, Ser D, No 87, Turku, Finland, 1991.Google Scholar
  10. 10.
    Scott AT, Le IL, Easley ME. Surgical strategies – noninsertional Achilles tendinopathy. Foot Ankle Int. 2008;29:759–71.CrossRefGoogle Scholar
  11. 11.
    Józsa L, Kannus P. Human tendons: anatomy, physiology, and pathology. Champaign, IL: Human Kinetics; 1997.Google Scholar
  12. 12.
    Paavola M. Achilles tendon overuse injuries -diagnosis and treatment. Doctoral Thesis. Acta Univ Tamperensis 824, Tampere, Finland, 2001.Google Scholar
  13. 13.
    Järvinen TA, Kannus P, Paavola M, Järvinen TL, Jozsa L, Järvinen M. Achilles tendon injuries. Curr Opin Rheumatol. 2001;13:150–5.CrossRefGoogle Scholar
  14. 14.
    Magninian J. Surgical treatment of chronic Achilles tendinopathy: long-term results of the endoscopic technique. J Foot Ankle Surg. 2013;52:451–5.CrossRefGoogle Scholar
  15. 15.
    Pearce CJ, Carmichael J, Calder JD. Achilles tendinoscopy and plantar tendon release and division in the treatment of non-insertional Achilles tendinopathy. Foot Ankle Surg. 2012;18:124–7.CrossRefGoogle Scholar
  16. 16.
    Maffulli N, Testa V, Capasso G, Bifulco G, Binfield PM. Results of percutaneous longitudinal tenotomy for Achilles tendinopathy in middle-distance runners. Am J Sports Med. 1997;25:835–40.CrossRefGoogle Scholar
  17. 17.
    Sarimo J, Orava S. Fascial incision and adhesiolysis combined with radiofrequency microtenotomy in treatment of chronic mid-portion Achilles tendinopathy. Scand J Surg. 2011;100:125–7.CrossRefGoogle Scholar
  18. 18.
    Lehto MUK, Järvinen M, Suominen P. Chronic Achilles peritendinitis and retrocalcaneal bursitis. Long-term follow-up of surgically treated cases. Knee Surg Sports Traumatol Arthrosc. 1994;2:182–5.CrossRefGoogle Scholar
  19. 19.
    Wiegerinck JI, Kok AC, van Dijk CN. Surgical treatment of chronic retrocalcaneal bursitis. Arthroscopy. 2012;28:283–93.CrossRefGoogle Scholar
  20. 20.
    Johansson K, Sarimo J, Lempainen L, Laitala-Leinonen T, Orava S. Calcified spurs at the insertion of Achilles tendon: a clinical and histological study. Muscles Ligaments Tendons J. 2013;2:273–7.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Orava S, Karpakka J, Gorra A, Helal B, Kvist M, Pelttari S, Takala T. Anomalous soleus muscle as a cause of exertion pain in athletes. Clin Sports Med. 1989;1:205–10.Google Scholar
  22. 22.
    Roche AJ, Calder JD. Achilles tendinopathy: a review of the current concepts of treatment. J Bone Jt Surg. 2013;95-B:1299–37.CrossRefGoogle Scholar
  23. 23.
    Rolf C. Achilles tendon injuries – an overview. In: Chan KM, Fu F, Maffulli N, Rolf C, Kurosaka M, Liu S, editors. Controversies in orthopedic sports medicine. Hong Kong: Williams and Wilkins; 1998. p. 501–8.Google Scholar
  24. 24.
    Schepsis A, Wagner C, Leach R. Surgical management of Achilles tendon overuse injuries -a long-term follow-up study. Am J Sports Med. 1994;22:611–9.CrossRefGoogle Scholar
  25. 25.
    Tallon C, Coleman B, Khan K, Maffuli N. Outcome of surgery for chronic Achilles tendinopathy. Am J Sports Med. 2001;29:315–20.CrossRefGoogle Scholar
  26. 26.
    Paavola M, Orava S, Leppilahti J, Kannus P, Järvinen M. Chronic achilles tendon overuse injury: complications after surgical treatment. Am J Sports Med. 2000;28:634–42.CrossRefGoogle Scholar
  27. 27.
    Leppilahti J, Kaarela O, Teerikangas H, Raatikainen T, Orava S. Free tissue coverage of the wound complications following Achilles tendon rupture surgery. Clin Orthop. 1996;328:171–6.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Sakari Orava
    • 1
    • 2
    Email author
  • Lasse Lempainen
    • 1
    • 2
  • Janne Sarimo
    • 1
    • 2
  1. 1.NEO-Mehilainen HospitalTurkuFinland
  2. 2.Sports Trauma Research CenterTurkuFinland

Personalised recommendations