Clinical and Functional Outcomes of Gastrocnemius Recession for Chronic Achilles Tendinopathy.
BACKGROUND
Although gastrocnemius recession has been proposed and used in the treatment of chronic noninsertional Achilles tendinopathy, only weak evidence exists to support this operative indication. The purpose of our study was to assess the clinical and functional outcomes of patients treated with gastrocnemius recession at 2 institutions for this problem.


METHODS
Thirty-four patients were identified through our medical records and asked to participate in this study. Thirty patients (35 legs) responded to the invitation. Sixteen patients were eligible for clinical follow-up, and 14 patients responded by letter or telephone interview. Two patients did not want to participate, and 2 patients could not be reached. Data were collected by a satisfaction questionnaire, the Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire, a visual analog scale (VAS) for pain, a functional test battery, and a clinical examination.


RESULTS
A subgroup with preoperative data (n = 8) showed an increase in the mean VISA-A score from 39.5 to 91.9. The mean overall VISA-A score (n = 30) was 91.4 at follow-up. The mean VAS for pain score when walking decreased from 7.5 before surgery to 0.8 after surgery. Twenty-eight of 30 patients reported that they were satisfied with their results after surgery. Functional testing showed no difference in gastrocnemius-soleus function between the operated and nonoperated leg (n = 10).


CONCLUSIONS
The findings support the promising results from other studies regarding gastrocnemius recession as an effective and safe way of treating chronic Achilles tendinopathy. The patients recovered both in terms of pain and function.


METHODS
Level IV, retrospective case series.
Section for Foot and Ankle Surgery, Department of Orthopaedic Surgery, Østfold Hospital, Grålum, Norway mariusmolund@hotmail.com.
Marius
M
Molund
Department of Orthopaedic Surgery, St Olavs Hospital and Aleris Helse, Orkdal, Norway.
Saulius Rytas
SR
Lapinskas
Section for Foot and Ankle Surgery, Department of Orthopaedic Surgery, Østfold Hospital, Grålum, Norway.
Fredrik Andre
FA
Nilsen
Section for Foot and Ankle Surgery, Department of Orthopaedic Surgery, Oslo University Hospital Ullevål, Oslo, Norway.
Kjetil Harald
KH
Hvaal
D000125:Achilles Tendon / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010147:Pain Measurement; D020127:Recovery of Function; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D052256:Tendinopathy / Q000601:surgery*; D055815:Young Adult
tendon disorders