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Related Experiment Video

Updated: Feb 22, 2026

Author Spotlight: Unraveling the Mechanobiology of Tendon Impingement – A Multiaxial Murine Hind Limb Explant Model
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[Midportion Achilles tendinopathy].

J Weber1,2, T Buchhorn3

  • 1Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland. johannes1.weber@ukr.de.

Der Unfallchirurg
|September 19, 2017
PubMed
Summary
This summary is machine-generated.

Midportion Achilles tendinopathy is common in runners, causing pain and swelling. Eccentric exercise is the gold standard for conservative treatment, with surgery an option if nonoperative methods fail.

Keywords:
Achilles tendinopathyConservative treatmentInflammationReturn to sportsSurgery

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Rehabilitation

Background:

  • Midportion Achilles tendinopathy affects runners, presenting with pain, swelling, and reduced performance.
  • Diagnosis relies on clinical symptoms and imaging (sonography, MRI).
  • Histopathology reveals degenerative changes, potentially with inflammation.

Purpose of the Study:

  • To review current treatment options for midportion Achilles tendinopathy.
  • To compare the efficacy of conservative and surgical interventions.
  • To provide an overview of diagnostic and therapeutic strategies.

Main Methods:

  • Literature review of conservative and surgical treatments for Achilles tendinopathy.
  • Analysis of evidence supporting eccentric exercise, extracorporeal shockwave (ECSW) therapy, and corticosteroid injections.
  • Evaluation of surgical outcomes for open, minimally invasive, and tenoscopic procedures.

Main Results:

  • Eccentric exercise protocols are the gold standard for conservative treatment.
  • Extracorporeal shockwave (ECSW) therapy and corticosteroid injections are secondary options.
  • Surgery is considered for ~25% of cases with unsatisfactory conservative results, yielding ~80% satisfaction rates.
  • Full recovery can take up to 18 months for both conservative and surgical treatments.

Conclusions:

  • Conservative management, particularly eccentric exercises, should be the first line of treatment for midportion Achilles tendinopathy.
  • Surgical intervention offers good outcomes for refractory cases.
  • Patient recovery and return to sport are variable, emphasizing the need for tailored rehabilitation programs.