Surgery for chronic Achilles tendinopathy produces worse results in women
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Updated: Jul 3, 2026
A Treatment Protocol for Achilles Tendinopathy with Extracorporeal Shockwave Therapy
Published on: August 2, 2024
Nicola Maffulli1, Vittorino Testa, Giovanni Capasso
1Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Stoke on Trent, UK.
Purpose:
To report the middle term outcome in male and female patients who underwent surgery for chronic recalcitrant Achilles tendinopathy.
Methods:
We tried to match each of the 58 female patients with a diagnosis of tendinopathy of the main body of the Achilles tendon with a male patient with tendinopathy of the main body of the Achilles tendon who was within two years of age at the time of operation. A match accordingly was possible for 41 female subjects.
Results:
Female patients were shorter and lighter than male patients. They had similar BMI, lower calf circumference, similar side-to-side calf circumference differences, and greater subcutaneous body fat than men. Of the 41 sedentary patients, only 25 reported an excellent or good result. Of these, three had undergone a further exploration of the Achilles tendon. The remaining patients could not return to their normal levels of activity despite prolonged supervised post-operative physiotherapy, with cryotherapy, massage, ultrasound, pulsed magnetic, and laser therapy.
Conclusion:
Females experience more prolonged recovery, more complications, and a greater risk of further surgery than males with recalcitrant Achilles tendinopathy.
