title: Good outcome after stripping the plantaris tendon in patients with chronic mid-portion Achilles tendinopathy.
abstract: OBJECTIVE
  Achilles tendinopathy is a problem that is generally difficult to treat. The pain is frequently most prominent on the medial side of the mid-portion of the tendon, where the plantaris tendon is running parallel to the Achilles tendon. The purpose of this study was to assess whether excision of the plantaris tendon would relieve symptoms.
  
  
  METHODS
  Three patients with pain and stiffness at the mid-portion of the Achilles tendon were treated by excision of the plantaris tendon. Preoperatively, these patients experienced recognizable tenderness on palpation of the medial side of the mid-portion of the Achilles tendon with localized nodular thickening at 4-7 cm proximal to the insertion. MRI indicated Achilles tendinopathy with the involvement of the plantaris tendon.
  
  
  RESULTS
  The plantaris tendon was bluntly retrieved and excised with a tendon stripper through a 4-cm incision in the proximal calf. We report a good-to-excellent outcome of this novel procedure in three patients with chronic mid-portion Achilles tendinopathy
  
  
  CONCLUSIONS
  The medial pain might be based on the involvement of the plantaris tendon in the process.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Center, DE Amsterdam, The Netherlands. m.n.vansterkenburg@amc.uva.nl
authors.forename: Maayke N
authors.initials: MN
authors.lastname: van Sterkenburg
authors.forename: Gino M M J
authors.initials: GM
authors.lastname: Kerkhoffs
authors.forename: C Niek
authors.initials: CN
authors.lastname: van Dijk
mesh_terms: D000125:Achilles Tendon / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D019637:Orthopedic Procedures / Q000379:methods*; D010147:Pain Measurement; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D052256:Tendinopathy / Q000175:diagnosis / Q000601:surgery*; D013710:Tendons / Q000601:surgery; D016896:Treatment Outcome