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Achilles tendon injuries.

T A Järvinen1, P Kannus, M Paavola

  • 1Institute of Medical Technology and Medical School, University of Tampere, Tampere, Finland.

Current Opinion in Rheumatology
|February 27, 2001
PubMed
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Achilles tendon injuries, including tendinopathy and ruptures, are rising with increased sports participation. While most injuries improve with conservative care, surgery is reserved for specific cases, and many questions remain about Achilles tendon disorders.

Area of Science:

  • Orthopedics
  • Sports Medicine
  • Biomedical Engineering

Background:

  • The Achilles tendon, crucial for locomotion, is susceptible to overuse injuries and ruptures, particularly in athletic populations.
  • Increased participation in sports has led to a documented rise in Achilles tendon injuries in industrialized nations.
  • Achilles tendinopathy, marked by pain and swelling, is the most common overuse injury, impairing physical activity.

Purpose of the Study:

  • To review the current understanding of Achilles tendon injuries, encompassing tendinopathy and complete ruptures.
  • To discuss the diagnostic criteria and management strategies for Achilles tendon disorders.
  • To identify knowledge gaps and areas requiring further research in Achilles tendon pathology.

Main Methods:

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  • Review of existing literature on Achilles tendon injuries, including clinical diagnoses and histopathologic findings.
  • Analysis of treatment outcomes for both conservative and operative interventions for tendinopathy and ruptures.
  • Synthesis of current evidence regarding the etiology, pathogenesis, and clinical management of Achilles tendon disorders.

    • Main Results:

    • Achilles tendinopathy typically responds well to conservative treatment; surgery is generally indicated for cases unresponsive to nonoperative management.
    • Complete Achilles tendon ruptures often occur suddenly during high-impact sports, sometimes without prior symptoms, despite evidence of pre-existing degeneration.
    • Treatment decisions for ruptures depend on patient factors, with surgery favored for young, active individuals and delayed diagnoses, while conservative care is acceptable for older, less active patients.

    Conclusions:

    • Conservative management is effective for most Achilles tendon injuries, with surgery reserved for specific indications.
    • Optimal treatment for Achilles tendon ruptures is debated, with patient age and activity level influencing the choice between operative and nonoperative approaches.
    • Further well-controlled studies are essential to elucidate the causes, pathogenesis, and optimal management of Achilles tendon disorders, enabling tailored treatment protocols.