title: Central tendon splitting combined with SutureBridge double-row technique as a surgical treatment for insertional Achilles tendinopathy.
abstract: BACKGROUND
  Surgical treatment of insertional Achilles tendinopathy should be considered when a variety of conservative measures fail. To achieve a satisfactory outcome, thorough debridement of the Achilles tendon is critical, besides excision of the bursitis and the calcaneal exostosis. Central tendon-splitting provides straightforward access to the calcified or degenerative tissue within the Achilles tendon. For Achilles tendon reconstruction if detachment is present, several surgical techniques have been reported. Controversy surrounds the technique can provide maximum security for reattachment of the Achilles tendon. The SutureBridge double-row construct, initially used in rotator cuff repair, is probably a good choice.
  
  
  METHODS
  Ten consecutive patients with insertional Achilles tendinopathy underwent tendon reattachment using the SutureBridge technique through a central tendon-splitting approach. We retrospectively evaluated the surgical outcomes, which included pre- and postoperative visual analog scale (VAS), postoperative Maryland Foot Score (MFS), postoperative range of motion of the affected ankle, and related complications. Follow-up was performed in the outpatient department.
  
  
  RESULTS
  One patient was lost to follow-up. Nine patients (two male and seven female; 12 feet) were reviewed with a minimum follow-up of six months (range 6-30 months). The postoperative VAS pain scores were markedly lower than the preoperative scores. Postoperative MFS was 92.1±8.0 (range 74-100). No intra- or postoperative complications were found, except for one case of delayed healing incision. At last follow-up, all affected ankles achieved their normal range of motion, and patients were able to resume daily activities without any assistive device.
  
  
  CONCLUSIONS
  Although a randomized control trial with a larger sample may be necessary to compare the central tendon-splitting combined with the SutureBridge technique with other techniques, our results confirmed that it was a promising alternative for treatment of insertional Achilles tendinopathy.
authors.affiliation: Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Lin
authors.forename: Zhi-wei
authors.initials: ZW
authors.lastname: Wang
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Jiang
authors.initials: J
authors.lastname: Pan
authors.forename: Tie-bing
authors.initials: TB
authors.lastname: Qu
authors.forename: Yong
authors.initials: Y
authors.lastname: Hai
mesh_terms: D000125:Achilles Tendon / Q000601:surgery*; D002111:Calcaneus / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D053441:Suture Anchors; D052256:Tendinopathy / Q000601:surgery*