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Ultrasound and surg...
Ultrasound and surgical inspection of plantaris tendon involvement in chronic painful insertional Achilles tendinopathy: A case series
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- Alfredson, Håkan (author)
- Umeå universitet,Avdelningen för idrottsmedicin,Institute of Sports, Exercise and Health, University College Hospital, London, UK
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- Masci, Lorenzo (author)
- Department of Sports and Exercise Medicine, Queen Mary University, London, United Kingdom
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- Spang, Christoph (author)
- Umeå universitet,Anatomi,Research Unit, Orthopaedic Spine Center, Dr. Alfen, Würzburg, Germany
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(creator_code:org_t)
- 2021-03-22
- 2021
- English.
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In: BMJ Open Sport and Exercise Medicine. - : BMJ Publishing Group Ltd. - 2055-7647. ; 7:1
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Abstract
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- Objectives: Chronic painful insertional Achilles tendinopathy is known to be difficult to manage. The diagnosis is not always easy because multiple different tissues can be involved. The plantaris tendon has recently been described to frequently be involved in chronic painful mid-portion Achilles tendinopathy. This study aimed to evaluate possible plantaris tendon involvement in patients with chronic painful insertional Achilles tendinopathy.Methods: Ninety-nine consecutive patients (74 males, 25 females) with a mean age of 40 years (range 24-64) who were surgically treated for insertional Achilles tendinopathy, were included. Clinical examination, ultrasound (US)+Doppler examination, and surgical findings were used to evaluate plantaris tendon involvement.Results: In 48/99 patients, there were clinical symptoms of plantaris tendon involvement with pain and tenderness located medially at the Achilles tendon insertion. In all these cases, surgical findings showed a thick and wide plantaris tendon together with a richly vascularised fatty infiltration between the plantaris and Achilles tendon. US examination suspected plantaris involvement in 32/48 patients.Conclusion: Plantaris tendon involvement can potentially be part of the pathology in chronic painful insertional Achilles tendinopathy and should be considered for diagnosis and treatment when there is distinct and focal medial pain and tenderness.Level of evidence: IV case series.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Idrottsvetenskap (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Sport and Fitness Sciences (hsv//eng)
Keyword
- achilles
- ankle
- surgery
- tendinopathy
- tendinosis
Publication and Content Type
- ref (subject category)
- art (subject category)
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