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Calcific insertional Achilles tendinopathy: reattachment with bone anchors
Nicola Maffulli1, Vittorino Testa, Giovanni Capasso
1Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, North Staffordshire Hospital, Staffordshire, England.
The American Journal of Sports Medicine
|February 3, 2004
Summary
Surgical removal of calcific deposits and reinsertion of the Achilles tendon with bone anchors offers a safe and effective treatment for recalcitrant insertional Achilles tendinopathy, improving patient outcomes.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Musculoskeletal Disorders
Background:
- Recalcitrant calcific insertional Achilles tendinopathy presents a significant treatment challenge.
- Current treatment options for this condition are often limited in efficacy.
Purpose of the Study:
- To evaluate the safety and effectiveness of surgical intervention for calcific insertional Achilles tendinopathy.
- To assess the outcomes of Achilles tendon reinsertion with bone anchors after calcific deposit removal.
Main Methods:
- A longitudinal study was conducted on 21 patients (21 feet) with recalcitrant calcific insertional Achilles tendinopathy.
- Surgical treatment involved disinsertion, removal of calcific deposits, and reinsertion of the Achilles tendon using bone anchors.
Main Results:
- At an average follow-up of 48.4 months, 11 patients reported excellent results and 5 reported good results.
- The VISA-A questionnaire scores significantly improved from 62.4% to 88.1% post-surgery.
- Five patients were unable to return to their previous level of sporting activity.
Conclusions:
- Surgical excision of calcific deposits with Achilles tendon reinsertion using suture anchors is recommended for recalcitrant insertional Achilles tendinopathy.
- The procedure demonstrated safety, with no instances of traumatic reattachment failure.
- While generally effective, a subset of patients may not regain their pre-injury activity levels.