Functional Outcomes of Insertional Achilles Tendinopathy Treatment: A Systematic Review.
| Autor: | Jarin IJ; Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY., Bäcker HC; Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY., Vosseller JT; Jacksonville Orthopaedic Institute, Jacksonville, Florida. |
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| Jazyk: | angličtina |
| Zdroj: | JBJS reviews [JBJS Rev] 2021 Jun 14; Vol. 9 (6). Date of Electronic Publication: 2021 Jun 14. |
| DOI: | e20.00110 |
| Abstrakt: | Background: Achilles tendinopathy is a common clinical problem that can be either insertional or noninsertional, and effective treatment of each type can vary. We sought to investigate the current evidence on different treatment methods for insertional Achilles tendinopathy with a focus on functional outcomes. Methods: We performed a systematic review of the available literature using the PubMed/MEDLINE and Cochrane Central Register of Controlled Trials databases. Data from included studies were categorized according to treatment method and reported with respect to functional outcomes and complications. Results: A total of 1,457 abstracts were reviewed; 54 studies with 2,177 patients met the inclusion criteria. Among the 54 studies, 6 operative techniques and 6 nonoperative treatments were evaluated. Conclusions: Eccentric exercises and low-energy extracorporeal shockwave therapy (ESWT) have the greatest evidence for the initial management of insertional Achilles tendinopathy. ESWT has been increasingly studied in recent years, but more high-quality evidence is needed. Operative treatment with tenotomy, debridement, retrocalcaneal bursectomy, and calcaneal exostectomy is effective. Flexor hallucis longus tendon transfer may benefit cases of more severe disease. Minimally invasive procedures have a potential role in the treatment algorithm and require more rigorous study. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Competing Interests: Disclosure: The authors indicated that no external funding was received for any aspect of this work. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/JBJSREV/A704). (Copyright © 2021 by The Journal of Bone and Joint Surgery, Incorporated.) |
| Databáze: | MEDLINE |
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