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Insertional Achilles Tendinopathy: Occupational Outcomes in the Military
Greg E Lausé1, Rachel A Egbert1, Paul M Ryan1
1Tripler Army Medical Center, Honolulu, Hawaii.
Foot & Ankle Specialist
|October 25, 2021
Summary
Surgical management of insertional Achilles tendinopathy (IAT) significantly improved pain scores and facilitated return to military duty for many patients. However, a high complication rate necessitates careful consideration of risks and benefits.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Musculoskeletal Disorders
Background:
- Insertional Achilles tendinopathy (IAT) is a debilitating condition affecting active individuals.
- Non-operative treatments often yield suboptimal results for IAT.
- Surgical intervention is considered for persistent cases impacting military duty.
Purpose of the Study:
- To evaluate the outcomes of surgical management for insertional Achilles tendinopathy (IAT).
- To assess pain reduction, return to running, and return to military duty rates post-surgery.
- To identify complications associated with IAT surgery.
Main Methods:
- Retrospective review of 113 patients diagnosed with IAT.
- Data collected included Visual Analog Scale (VAS) pain scores, return to run, and return to military duty.
- Follow-up averaged 42 months, with analysis of surgical outcomes.
Main Results:
- VAS pain scores significantly improved from 5.4 preoperatively to 2.9 at 24 months post-surgery.
- Mean return to run time was 9 months.
- 80% of patients returned to military duty within one year, though overall complication rates were noted to be high.
Conclusions:
- Surgical management of IAT offers a viable treatment option for active duty personnel with significant pain improvement and high return-to-duty rates.
- The complication rate requires careful patient and provider discussion regarding risks, benefits, and treatment duration.
- Further research may explore strategies to mitigate surgical complications in IAT patients.
