Endoscopic surgery in chronic achilles tendinopathies: A preliminary report.
OBJECTIVE
The objective of this prospective study was to evaluate preliminary results of an endoscopic-assisted surgical technique for patients suffering from chronic Achilles tendinopathies.


METHODS
Case series.


METHODS
Endoscopic operations were performed on 7 consecutive patients involved in recreational sports suffering from chronic Achilles tendon (AT) lesions in whom conservative treatment had failed. Diagnoses included 2 patients with pure peritendinitis, 4 with peritendinitis and degenerative tendinosis, and 1 with a chronic partial tear. Patients were preoperatively and postoperatively evaluated at a mean follow-up period of 16 months (range, 6 to 27 months) with a 0-100 points rating system. All patients were studied preoperatively with magnetic resonance imaging (MRI) and 6 were re-evaluated with the same procedure after surgery. All surgical interventions were performed on an ambulatory basis and 5 under local anesthesia. The surgical endoscopic technique consisted of peritenon release and debridement in cases with pure peritendinitis. In addition, 2 longitudinal tenotomies were performed in cases with degenerative tendinosis or partial tears.


RESULTS
According to the scoring system used, all 7 patients had improved final outcome after surgery from a mean of 39 points preoperatively to 88 points postoperatively. The patient with an AT partial tear achieved the lowest score. The only complications were a minor hematoma and edema that resolved spontaneously. Postoperative MRI in patients with tendinosis failed to show evidence of degenerative areas.


CONCLUSIONS
Endoscopic surgery may be a valid alternative to treat Achilles tendinopathies unresponsive to conservative treatment because of potential lower morbidity.
Maquirriain
Javier
J
Orthopaedic Department, Centro Nacional de Alto Rendimiento Deportivo, Institute of Orthopaedics C. E. Otolenghi, Italian Hospital, Buenos Aires, Argentina.
Ayerza
Miguel
M
Costa-Paz
Matías
M
Muscolo
D Luis
DL
D000125:Achilles Tendon / Q000473:pathology / Q000601:surgery*; D000328:Adult; D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D010146:Pain / Q000601:surgery; D013577:Syndrome; D052256:Tendinopathy / Q000601:surgery