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A Treatment Protocol for Achilles Tendinopathy with Extracorporeal Shockwave Therapy
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The long-term outcome of tendon lengthening for chronic Achilles tendon pain
Matthew L Costa1, Simon T Donell, Keith Tucker
1Warwick Medical School, Clinical Sciences Building, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV22DX, United Kingdom. mattcosta@hotmail.com
Background:
The purpose of this study was to assess the long-term results of tendon lengthening surgery for the treatment of chronic Achilles tendon pain.
Methods:
The results of 21 procedures in 18 patients were assessed. Each patient had an open Z-plasty to lengthen the Achilles tendon by 1 cm.
Results:
Results showed a long-term (7.5 years) reduction in visual analogue pain scores for sporting activity in 20 of 21 procedures (median 50 point reduction, p < 0.0005). The tendon lengthening was apparent in a mean increase in dorsiflexion of 5 degrees. Two patients had minor gait abnormalities postoperatively. One patient had a reduction in plantarflexion power on the operated side, but five patients had improved power compared to the nonoperated limb. One major and five minor surgical complications were noted.
Conclusions:
The retrospective nature of this study must be noted in drawing conclusions. However, the results suggest excellent long-term reduction of Achilles pain after tendon lengthening. This must be weighed against a relatively high complication rate for any procedure in this region. This treatment does not appear to cause long-term deficits in plantarflexion power or gait.
