Wataru Miyamoto1, Masato Takao, Takashi Matsushita. 1. Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo 173-8605, Japan. miyamoto@med.teikyo-u.ac.jp
Abstract
PURPOSE: The purpose of this study was to investigate the clinical results of reconstructive surgery using a bone-patellar tendon (BPT) autograft for athletes with intractable insertional Achilles tendinopathy. METHODS: Ten athletes who underwent reconstructive surgery using a BPT autograft were included in this study. Indications were (1) persistent symptoms in spite of conservative therapy for 6 months, and (2) diffuse high intensity changes of an entire cross-section of the tendon at its insertion point on T2-weighted magnetic resonance imaging (MRI), with clinical follow-up of more than 24 months after surgery. Clinical evaluation was performed before surgery and at the most recent follow-up [median: 32 (25-48) months], and radiological assessment at 1 year after surgery. RESULTS: The median Achilles tendon rupture score at the most recent follow-up was 92.5 (85-100) points. The median visual analogue scale score improved significantly from 90 (85-100) points preoperatively to 5 (0-10) points at the most recent follow-up (P < 0.01). Based on T2-weighted MRI, the anterior-posterior width of the grafted BPT was approximately twice that of the intact nonsurgical contralateral tendon insertion in all patients at 1 year after surgery. The median time from surgery to ability to return to full sports activity was 13.5 months. CONCLUSIONS: The reconstructive surgery presented in this study can be useful for athletes who suffer from insertional Achilles tendinopathy with a wide area of diseased tendon at the insertion point. LEVEL OF EVIDENCE: IV.
PURPOSE: The purpose of this study was to investigate the clinical results of reconstructive surgery using a bone-patellar tendon (BPT) autograft for athletes with intractable insertional Achilles tendinopathy. METHODS: Ten athletes who underwent reconstructive surgery using a BPT autograft were included in this study. Indications were (1) persistent symptoms in spite of conservative therapy for 6 months, and (2) diffuse high intensity changes of an entire cross-section of the tendon at its insertion point on T2-weighted magnetic resonance imaging (MRI), with clinical follow-up of more than 24 months after surgery. Clinical evaluation was performed before surgery and at the most recent follow-up [median: 32 (25-48) months], and radiological assessment at 1 year after surgery. RESULTS: The median Achilles tendon rupture score at the most recent follow-up was 92.5 (85-100) points. The median visual analogue scale score improved significantly from 90 (85-100) points preoperatively to 5 (0-10) points at the most recent follow-up (P < 0.01). Based on T2-weighted MRI, the anterior-posterior width of the grafted BPT was approximately twice that of the intact nonsurgical contralateral tendon insertion in all patients at 1 year after surgery. The median time from surgery to ability to return to full sports activity was 13.5 months. CONCLUSIONS: The reconstructive surgery presented in this study can be useful for athletes who suffer from insertional Achilles tendinopathy with a wide area of diseased tendon at the insertion point. LEVEL OF EVIDENCE: IV.
Authors: M Benjamin; T Kumai; S Milz; B M Boszczyk; A A Boszczyk; J R Ralphs Journal: Comp Biochem Physiol A Mol Integr Physiol Date: 2002-12 Impact factor: 2.320
Authors: R Rousseau; A Gerometta; S Fogerty; E Rolland; Y Catonné; F Khiami Journal: Knee Surg Sports Traumatol Arthrosc Date: 2014-04-19 Impact factor: 4.342