Surgical Takedown Approaches to Insertional Achilles Tendinopathy: A Systematic Review

Autor: Tyler Tewilliager, Dominick J. Casciato, John Thompson, Eric So, Jaime Ahluwalia, Kevin Nguyen, Mark A. Prissel
Rok vydání: 2021
Předmět:
Zdroj: The Journal of Foot and Ankle Surgery. 60:1217-1221
ISSN: 1067-2516
DOI: 10.1053/j.jfas.2021.04.015
Popis: Various techniques of surgical detachment for treatment of insertional Achilles tendinopathy have been described, including lateral release, medial release, central tendon splitting (CTS), and complete detachment. A systematic review of electronic databases was performed, encompassing 17 studies involving 703 patients and 746 feet, to compare outcomes associated with surgical takedown techniques. Observed results include wound complication rates (CTS 2.8%; Lateral 0%; Medial 0.4%; Complete 1.3%), postoperative rupture rates (CTS 0.7%; Lateral 0.8%; Medial 0.7%; Complete 2.6%), rate of revision (CTS 0.4%; Lateral 0.9%; Medial 4.2%; Complete 2.6%), rate of infection (CTS 1.1%; Lateral 1.7%; Medial 3.7%; Complete 6.5%). Lateral takedown group was found to have a statistically significant lower rate of complications compared to the complete takedown group (p = .0029). In light of these results, it is recommended that patient characteristics such as case specific tendon pathology and calcaneal morphology take precedent in determining the surgical approach to Achilles takedown.
Databáze: OpenAIRE