Management of achilles tendinopathy by ultrasound-guided percutaneous tenotomy

Vittorino Testa, Giovanni Capasso, Franco Benazzo, Nicola Maffulli

Research output: Contribution to journalArticle

117 Citations (Scopus)

Abstract

Purpose: To report the middle to long-term results of ultrasound-guided percutaneous longitudinal tenotomy of the Achilles tendon Method: Seventy-five athletes with unilateral Achilles tendinopathy underwent ultrasound-guided percutaneous longitudinal tenotomy under local anesthetic infiltration after failure of conservative management. Sixty-three patients were reviewed at least 36 months after the operation (51 ± 18.2 months). Results Thirty-five patients were rated excellent, 12 good, 9 fair, and 7 poor. Nine of the 16 patients with a fair or poor result underwent a formal exploration of the Achilles tendon 7-12 months after the index procedure. The operated tendons remained thickened and the ultrasonographic appearance of operated tendons remained abnormal even 8 yr after the operation, without interfering with physical training. Isometric maximal muscle strength and isometric endurance gradually returned to values similar to their contralateral unoperated tendon. Conclusions: Percutaneous longitudinal ultrasound-guided internal tenotomy is simple, can be performed on an outpatient basis, requires minimal follow-up care, does not hinder further surgery should it be unsuccessful, and, in our experience, has produced no significant complications. It should be considered in the management of chronic Achilles tendinopathy after failure of conservative management. However, patients should be advised that, if they suffer from diffuse or multinodular tendinopathy or from pantendinopathy, a formal surgical exploration with stripping of the paratenon and multiple longitudinal tenotomies may be preferable.

Original languageEnglish
Pages (from-to)573-580
Number of pages8
JournalMedicine and Science in Sports and Exercise
Volume34
Issue number4
Publication statusPublished - 2002

Fingerprint

Tenotomy
Tendinopathy
Tendons
Achilles Tendon
Aftercare
Muscle Strength
Local Anesthetics
Athletes
Outpatients
Conservative Treatment

Keywords

  • Minimally invasive surgery
  • Outcome
  • Tendinosis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Orthopedics and Sports Medicine

Cite this

Management of achilles tendinopathy by ultrasound-guided percutaneous tenotomy. / Testa, Vittorino; Capasso, Giovanni; Benazzo, Franco; Maffulli, Nicola.

In: Medicine and Science in Sports and Exercise, Vol. 34, No. 4, 2002, p. 573-580.

Research output: Contribution to journalArticle

Testa, Vittorino ; Capasso, Giovanni ; Benazzo, Franco ; Maffulli, Nicola. / Management of achilles tendinopathy by ultrasound-guided percutaneous tenotomy. In: Medicine and Science in Sports and Exercise. 2002 ; Vol. 34, No. 4. pp. 573-580.
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