title: Release of the medial head of the gastrocnemius for Achilles tendinopathy in sedentary patients: a retrospective study.
abstract: OBJECTIVE
  Our aim was to ascertain whether releasing the medial head of he gastrocnemius improves clinical and functional outcomes of sedentary patients with long-standing tendinopathy of the main body of the Achilles tendon and allows return to daily activities.
  
  
  METHODS
  Eighteen patients (seven men, 11 women) underwent release of the gastrocnemius medial head to manage chronic unilateral Achilles tendinopathy. Pre- and postoperatively, each patient completed the Victorian Institute of Sports Assessment-Achilles tendon (VISA-A) questionnaire. The maximum calf circumference and isometric plantar flexion strength of the gastrocsoleus complex were measured in both the affected and the contralateral leg. Function was scored using the 4-point Boyden scale at the last assessment.
  
  
  RESULTS
  At the last appointment, at an average follow-up of 54 months, maximum calf circumference and strength of the operated leg were not significantly different than pre-operatively and were significantly lower than the contralateral leg. All patients could satisfactorily perform the same work and daily activities as before symptom onset. At the last follow-up, the average VISA-A score was improved from a preoperative average value of 52.3 to 75 (range 51-94) (p < .001).
  
  
  CONCLUSIONS
  This approach to managing isolated Achiles tendinopathy is safe, effective, low cost and allows safe return to preinjury daily activities.
authors.affiliation: Centre for Sports and Exercise Medicine, Queen Mary University of London, London, UK, n.maffulli@qmul.ac.uk.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
authors.forename: Angelo
authors.initials: A
authors.lastname: Del Buono
mesh_terms: D000125:Achilles Tendon / Q000601:surgery; D000328:Adult; D000368:Aged; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D019637:Orthopedic Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D062707:Return to Work; D057185:Sedentary Behavior; D052256:Tendinopathy / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome