Marius Molund1, Saulius Rytas Lapinskas2, Fredrik Andre Nilsen3, Kjetil Harald Hvaal4. 1. Section for Foot and Ankle Surgery, Department of Orthopaedic Surgery, Østfold Hospital, Grålum, Norway mariusmolund@hotmail.com. 2. Department of Orthopaedic Surgery, St Olavs Hospital and Aleris Helse, Orkdal, Norway. 3. Section for Foot and Ankle Surgery, Department of Orthopaedic Surgery, Østfold Hospital, Grålum, Norway. 4. Section for Foot and Ankle Surgery, Department of Orthopaedic Surgery, Oslo University Hospital Ullevål, Oslo, Norway.
Abstract
BACKGROUND: Although gastrocnemius recession has been proposed and used in the treatment of chronic noninsertional Achilles tendinopathy, only weak evidence exists to support this operative indication. The purpose of our study was to assess the clinical and functional outcomes of patients treated with gastrocnemius recession at 2 institutions for this problem. METHODS: Thirty-four patients were identified through our medical records and asked to participate in this study. Thirty patients (35 legs) responded to the invitation. Sixteen patients were eligible for clinical follow-up, and 14 patients responded by letter or telephone interview. Two patients did not want to participate, and 2 patients could not be reached. Data were collected by a satisfaction questionnaire, the Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire, a visual analog scale (VAS) for pain, a functional test battery, and a clinical examination. RESULTS: A subgroup with preoperative data (n = 8) showed an increase in the mean VISA-A score from 39.5 to 91.9. The mean overall VISA-A score (n = 30) was 91.4 at follow-up. The mean VAS for pain score when walking decreased from 7.5 before surgery to 0.8 after surgery. Twenty-eight of 30 patients reported that they were satisfied with their results after surgery. Functional testing showed no difference in gastrocnemius-soleus function between the operated and nonoperated leg (n = 10). CONCLUSION: The findings support the promising results from other studies regarding gastrocnemius recession as an effective and safe way of treating chronic Achilles tendinopathy. The patients recovered both in terms of pain and function. LEVEL OF EVIDENCE: Level IV, retrospective case series.
BACKGROUND: Although gastrocnemius recession has been proposed and used in the treatment of chronic noninsertional Achilles tendinopathy, only weak evidence exists to support this operative indication. The purpose of our study was to assess the clinical and functional outcomes of patients treated with gastrocnemius recession at 2 institutions for this problem. METHODS: Thirty-four patients were identified through our medical records and asked to participate in this study. Thirty patients (35 legs) responded to the invitation. Sixteen patients were eligible for clinical follow-up, and 14 patients responded by letter or telephone interview. Two patients did not want to participate, and 2 patients could not be reached. Data were collected by a satisfaction questionnaire, the Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire, a visual analog scale (VAS) for pain, a functional test battery, and a clinical examination. RESULTS: A subgroup with preoperative data (n = 8) showed an increase in the mean VISA-A score from 39.5 to 91.9. The mean overall VISA-A score (n = 30) was 91.4 at follow-up. The mean VAS for pain score when walking decreased from 7.5 before surgery to 0.8 after surgery. Twenty-eight of 30 patients reported that they were satisfied with their results after surgery. Functional testing showed no difference in gastrocnemius-soleus function between the operated and nonoperated leg (n = 10). CONCLUSION: The findings support the promising results from other studies regarding gastrocnemius recession as an effective and safe way of treating chronic Achilles tendinopathy. The patients recovered both in terms of pain and function. LEVEL OF EVIDENCE: Level IV, retrospective case series.
Authors: Karin Grävare Silbernagel; Peter Malliaras; Robert-Jan de Vos; Shawn Hanlon; Mitchel Molenaar; Håkan Alfredson; Inge van den Akker-Scheek; Jarrod Antflick; Mathijs van Ark; Kenneth Färnqvist; Zubair Haleem; Jean-Francois Kaux; Paul Kirwan; Bhavesh Kumar; Trevor Lewis; Adrian Mallows; Lorenzo Masci; Dylan Morrissey; Myles Murphy; Richard Newsham-West; Richard Norris; Seth O'Neill; Koen Peers; Igor Sancho; Kayla Seymore; Patrick Vallance; Arco van der Vlist; Bill Vicenzino Journal: Sports Med Date: 2021-11-19 Impact factor: 11.136