title: Different distributions of operative diagnoses for Achilles tendon overuse injuries in Italian and Finnish athletes.
abstract: BACKGROUND
  the origin of chronic Achilles tendinopathy (AT) is currently unclear and epidemiological factors, such as ethnicity, may be associated.
  
  
  METHODS
  intraoperative findings from the treatment of 865 Finnish and 156 Italian athletic patients with chronic Achilles tendon related pain were evaluated, retrospectively. The mean age was 34 years (range, 18 to 65 years) in the Finnish and 29 years (range, 17-63 years) in the Italian patients. In total, 786 patients were males and 226 females of which 84 and 87% Finnish, respectively. Data were collected, retrospectively from patient records. The differences in the frequencies of operative findings were assessed for statistical significance.
  
  
  RESULTS
  retrocalcaneal bursitis, partial tear and chronic paratenonitis were the most prevalent findings in patients with chronic AT undergoing surgery. Tendinosis and chronic paratenonitis were significantly (p=0.011) more common in Finnish athletes. Italian patients exhibited significantly (p<0.001) more insertional calcific tendinopathy (heel spurs) and prominent posterosuperior calcaneal corners (Haglund's heel).
  
  
  CONCLUSIONS
  ethnicity appears to be associated with specific characteristics of overuse-related Achilles tendon pathology. This is an issue that should be considered in the planning of genetic research on AT.
authors.affiliation: Department of Paavo Nurmi Center, Turun Yliopisto, Turku, Finland.
authors.forename: Kristian
authors.initials: K
authors.lastname: Johansson
authors.affiliation: Hospital Neo, Turku, Finland.
authors.forename: Lasse
authors.initials: L
authors.lastname: Lempainen
authors.affiliation: Hospital Neo, Turku, Finland.
authors.forename: Janne
authors.initials: J
authors.lastname: Sarimo
authors.affiliation: Skeletal Biology Consortium, Department of Cell Biology and Anatomy, University of Turku, Turku, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Laitala-Leinonen
authors.affiliation: Hospital Neo, Turku, Finland.
authors.forename: Sakari
authors.initials: S
authors.lastname: Orava
keywords: Achilles tendon; overuse injury; surgery; tendinopathy