title: Low-Energy Extracorporeal Shock-Wave Therapy in the Treatment of Chronic Insertional Achilles Tendinopathy: A Case Series.
abstract: Introduction. We report the results of a series of 40 patients with chronic insertional Achilles tendinopathy treated with low-energy ESWT after the failure of a 3-month program of eccentric exercises alone.Methods and Materials. 40 patients, 28 (70%) males and 12 (30%) females, were treated between January and December 2014. All patients were previously treated with only eccentric exercises for a 3-month period. The treatment protocol included 4 sessions of ESWT with a 2-week interval, from 800 shots in each one (4 Hz, 14 KeV), together with eccentric exercises. Visual Analogue Scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) Hindfoot score were recorded.Results. At the 12-month follow-up, 26 (65.0%) patients did not complain about pain (VAS < 2), 11 (27.5%) patients got back to normal activities despite residual pain (VAS 2-4), and 3 (7.5%) of the patients still complained about pain (VAS > 4). There was no significative improvement in both scores after eccentric exercises alone. Mean VAS improvement was 5.8 ± 1.3 SD points (P< 0.001). Mean AOFAS Hindfoot score improvement was 19.8 ± 5.0 SD points (P< 0.001).Conclusions. ESWT is recommended, in combination with an eccentric exercise program, in patients with chronic Achilles tendinopathy being both insertional and not.
authors.affiliation: Dipartimento di Chirurgia Generale e Specialità Medico Chirurgiche, Sez. Ortopedia e Traumatologia A. O. U. Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Pavone
authors.affiliation: Dipartimento di Chirurgia Generale e Specialità Medico Chirurgiche, Sez. Ortopedia e Traumatologia A. O. U. Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Luca
authors.identifier: 0000-0001-8605-1746
authors.initials: L
authors.lastname: Cannavò
authors.affiliation: Dipartimento di Chirurgia Generale e Specialità Medico Chirurgiche, Sez. Ortopedia e Traumatologia A. O. U. Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Stefano
authors.affiliation: Dipartimento di Chirurgia Generale e Specialità Medico Chirurgiche, Sez. Ortopedia e Traumatologia A. O. U. Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Testa
authors.affiliation: Dipartimento di Chirurgia Generale e Specialità Medico Chirurgiche, Sez. Ortopedia e Traumatologia A. O. U. Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Costarella
authors.affiliation: Dipartimento di Chirurgia Generale e Specialità Medico Chirurgiche, Sez. Ortopedia e Traumatologia A. O. U. Policlinico-Vittorio Emanuele, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sessa
mesh_terms: D000125:Achilles Tendon / Q000473:pathology*; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D052256:Tendinopathy / Q000628:therapy*