Long-Term Prognosis of Patients With Achilles Tendinopathy

Abstract

To determine the long-term outcome of patients treated nonoperatively for acute or subchronic (duration of the symptoms before initiation of the treatment less than 6 months) Achilles tendinopathy, we performed a follow-up analysis on 83 of 107 patients an average 8 +/- 2 (SD) years after the initial contact. The analysis included a questionnaire, clinical examination, performance tests, muscle strength measurement, and ultrasonographic examination. Twenty-four of the 83 patients (29%) had to be operated on during the follow-up period. Seventy patients (84%) had full recovery of their activity level, and at 8 years' follow-up 78 patients (94%) were asymptomatic or had only mild pain with strenuous exercise. However, a clear side-to-side difference between the involved and the uninvolved sides was observed on the performance test, clinical examination, and ultrasonography. Also, 34 patients (41%) started to suffer from overuse symptoms in the initially uninvolved Achilles tendon. The results of our 8-year follow-up showed that the long-term prognosis of patients with acute-to-subchronic Achilles tendinopathy is favorable as determined by subjective and functional assessments. In the clinical and ultrasonographic examinations, mild-to-moderate changes were observed rather frequently in both the involved and initially uninvolved Achilles tendons, but the occurrence of these changes was not clearly related to the patients' symptoms.

An isokinetic eccentric programme for the management of chronic lateral epicondylar tendinopathy

“…Further, most authors underline the incomplete effectiveness of conventional treatment in neglecting strengthening exercises, and being both passive and lacking in induced tendon adaptations. 29 39 43 44 It is also well established that disuse and immobilisation provoke collagen and cross-linked concentration decline, inducing tissue weakness both structurally and materially. 21 In our study, while the non-strengthening programme of treatment applied in the CG group induced a significant reduction of pain on the VAS, it was certainly not as efficient as when combined with the newly designed eccentric training; the pain score still reaching 4.3 at the end of intervention.…”

Achilles tendinopathy: some aspects of basic science and clinical management

“…114 Although US can show alterations in the Achilles tendon with high specificity and sensitivity, it has, like MRI, a high incidence of false positive findings, 115 with mild to moderate changes observed in both the involved and uninvolved Achilles tendons not clearly related to the patients' symptoms. 116 After surgery, US does not appear to be able to differentiate patients who make a good recovery from those with tendon symptoms.…”

Exercise, orthoses and splinting for treating Achilles tendinopathy: a systematic review with meta-analysis

“…Insertional tendinopathy is defined by pain and localised swelling at the calcaneal attachment and is frequently associated with calcification and ‘bony spurs’, which may be palpable at this site 3. Data on the long-term prognosis of Achilles tendinopathy are sparse, although 84% of individuals reporting with acute or subcacute symptoms returned to full activity following a multimodal treatment programme 4. However, treatment responses vary.…”