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Ossification of Achilles tendon--report of three cases
Masahito Hatori1, Michimasa Matsuda, Shoichi Kokubun
1Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, Japan 980-8574. mhato@mail.cc.tohoku.ac.jp
Background:
Ossification of the Achilles tendon is reportedly an unusual condition. The microscopic features of such ossifications have been not well documented.
Methods:
We treated three patients with bilateral ossification of the Achilles tendon and examined the specimens microscopically. The patients were all male. Their ages ranged from 41 to 59 years with an average of 48 years. The chief complaint was pain in two cases and rupture of the Achilles tendon in one case. The ossification site was near the insertion in five feet and in the tendon body in one foot. They had no laboratory abnormalities.
Results:
Removal was performed in two cases. Microscopic examination revealed no active inflammation of the ossified tendon. Lamellar bone formation with bone marrow continuous with the extensive cartilage metaplasia, namely enchondral ossification, and osteoid formation in the granulation tissue, namely intramembranous ossification, were observed.
Conclusions:
Judging from the heavy work and bilateral occurrence in the present cases, repetitive microtrauma to the Achilles tendon and some predisposition are implicated as causative factors in the ossification.
