Achilles tendinopathy

Nicola Maffulli, Umile Giuseppe Longo, Anish R Kadakia, Filippo Spiezia*

*Corresponding author for this work

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Background: Achilles Tendinopathy (AT) is essentially a failed healing response with haphazard proliferation of tenocytes, abnormalities in tenocytes with disruption of collagen fibers, and subsequent increase in non-collagenous matrix. Methods: The diagnosis of Achilles tendinopathy is clinical, and MRI and utrasound imaging can be useful in differential diagnosis. Conservative manegement, open surgery or minimally invasive techniques are available. Injections and physical therapy are also vauable options. Results: Eccentric exercises are useful tools to manage the pathology. If the condition does not ameliorate, shock wave therapy, or nitric oxide patches might be considered. Peritendinous injections or injections at the interface between the Achilles tendon and Kager's triangle could be considered if physical therapy should fail. Surgery is indicated after 6 months of non-operative management. Conclusions: The clinical diagnosis and management of AT are not straightforward. Hence, patients should understand that symptoms may recur with either conservative or surgical approaches.

Original languageEnglish (US)
JournalFoot and Ankle Surgery
DOIs
StatePublished - Jan 1 2019

Fingerprint

Tendinopathy
Injections
Convulsive Therapy
Achilles Tendon
Minimally Invasive Surgical Procedures
Nitric Oxide
Differential Diagnosis
Collagen
Exercise
Pathology
Therapeutics
Tenocytes

Keywords

  • Achilles tendinopaty
  • Ankle
  • Injections
  • Sports trauma
  • Tendon

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Maffulli, Nicola ; Longo, Umile Giuseppe ; Kadakia, Anish R ; Spiezia, Filippo. / Achilles tendinopathy. In: Foot and Ankle Surgery. 2019.
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Achilles tendinopathy. / Maffulli, Nicola; Longo, Umile Giuseppe; Kadakia, Anish R; Spiezia, Filippo.

In: Foot and Ankle Surgery, 01.01.2019.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Achilles tendinopathy

AU - Maffulli, Nicola

AU - Longo, Umile Giuseppe

AU - Kadakia, Anish R

AU - Spiezia, Filippo

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Achilles Tendinopathy (AT) is essentially a failed healing response with haphazard proliferation of tenocytes, abnormalities in tenocytes with disruption of collagen fibers, and subsequent increase in non-collagenous matrix. Methods: The diagnosis of Achilles tendinopathy is clinical, and MRI and utrasound imaging can be useful in differential diagnosis. Conservative manegement, open surgery or minimally invasive techniques are available. Injections and physical therapy are also vauable options. Results: Eccentric exercises are useful tools to manage the pathology. If the condition does not ameliorate, shock wave therapy, or nitric oxide patches might be considered. Peritendinous injections or injections at the interface between the Achilles tendon and Kager's triangle could be considered if physical therapy should fail. Surgery is indicated after 6 months of non-operative management. Conclusions: The clinical diagnosis and management of AT are not straightforward. Hence, patients should understand that symptoms may recur with either conservative or surgical approaches.

AB - Background: Achilles Tendinopathy (AT) is essentially a failed healing response with haphazard proliferation of tenocytes, abnormalities in tenocytes with disruption of collagen fibers, and subsequent increase in non-collagenous matrix. Methods: The diagnosis of Achilles tendinopathy is clinical, and MRI and utrasound imaging can be useful in differential diagnosis. Conservative manegement, open surgery or minimally invasive techniques are available. Injections and physical therapy are also vauable options. Results: Eccentric exercises are useful tools to manage the pathology. If the condition does not ameliorate, shock wave therapy, or nitric oxide patches might be considered. Peritendinous injections or injections at the interface between the Achilles tendon and Kager's triangle could be considered if physical therapy should fail. Surgery is indicated after 6 months of non-operative management. Conclusions: The clinical diagnosis and management of AT are not straightforward. Hence, patients should understand that symptoms may recur with either conservative or surgical approaches.

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KW - Sports trauma

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