2015 ISAKOS Biennial Congress ePoster #123

Endoscopic Treatment of Non-Insertional Achilles Tendinopathy: 2 Year Follow-Up

Carlo Angelo Virrey Borbon, MD, FPOA, FPOSSM, FPOFAS, FPSS, Makati City, Metro Manila PHILIPPINES
Makati Medical Center, Makati City, Metro Manila, PHILIPPINES

FDA Status Not Applicable

Summary: Achilles tendoscopy is a good alternative treatment for patients with non-insertional Achilles tendinopathy who are nonresponsive to conservative management.

Abstract:

In the present generation where people live a healthier lifestyle, endurance sports such as marathon or triathlon, has become more and more popular in the regular athletes, in the weekend warrior population and even to those in the older age group. With the advent of this popularity, overuse tendon injuries has become more common in the clinical setting. Non-insertional Achilles tendinopathy has been one of the considerations in long-distance runners, presenting with pain on the posterior heel area. This condition may limit the performance of such patient and more importantly, may be precursory to gross rupture of the tendon. Conservative treatment is advocated in all patients. These, however, has a failure rate of 25-45%. Traditional open surgical approach is then offered to patients resistant to the conservative approach. Open surgery however, showed a high postoperative complication rate, majority of which are wound complications. A total of 12 patients diagnosed with non-insertional Achilles tendinopathy treated previously with conservative management, underwent Achilles tendoscopy, debridement and synovectomy. All underwent the same rehabilitation protocol and were examined at 6 weeks, 6 months, 1 and 2 years. Pre and post-operative AOFAS ankle/hindfoot scoring and VAS FA scoring system were used for evaluation. All patients had good to excellent results and all came back to pre-injury level of activity. 1 developed wound dehiscence at the portal site, which did not require further surgical management, Achilles tendoscopy is then a good alternative treatment for patients with Non-insertional Achilles Tendinopathy who did not improve with conservative treatment. This may offer the advantage of lower complication rate and possible earlier return to sports compared to conventional open treatments.