Review article
Noninsertional Achilles tendinopathy
Ivan Bojanić
orcid.org/0000-0002-4236-9637
; Klinika za ortopediju, KBC Zagreb, Zagreb
Sanja Križan
; Klinička bolnica „Merkur”, Zagreb
Damjan Dimnjaković
; Klinika za ortopediju, KBC Zagreb, Zagreb
Tamara Janjić
; KBC Zagreb, Zagreb
Tomislav Smoljanović
; Klinika za ortopediju, KBC Zagreb, Zagreb
Abstract
Achilles tendinopathy is a clinical condition characterized by pain and swelling in
and/or around the tendon, mainly arising from overuse. It may interfere with activities of daily
living, occupation and sports. Over the past thirty years, the incidence of Achilles tendinopathy
has been rising as a result of greater participation in sporting activities. However, one
third of patients with this condition are not physically active. The studies have shown that the
underlying cause of this condition is not an inflammation process but rather degenerative
changes. Suggested etiological factors for Achilles tendinopathy include intrinsic factors such
as malalignment of the lower extremity and extrinsic factors such as training errors and inappropriate
footwear. The diagnosis of Achilles tendinopathy is based on a thorough medical
history and detailed physical examination. Recommended imaging technique is ultrasound
scanning, while the MRI is recommended only in case of an unsuccessful initial treatment.
The aim of this article is to provide an overview of latest guidelines for conservative and
surgical treatment of noninsertional Achilles tendinopathy. Eccentric exercises are suggested
as the first treatment option, but if eccentric exercise program does not yield desired results,
it is recommended to perform some other method of conservative treatment. However,
about 25 % to 45.5 % of the patients with Achilles tendinopathy fail to respond to conservative
treatment and eventually require surgical intervention. Minimally invasive surgery, as
compared with open procedures, holds the potential benefits of decreased morbidity rates,
early functional rehabilitation and early return to daily life activities.
Keywords
Achilles tendon,; eccentric exercises; overuse injury; tendinopathy; treatment
Hrčak ID:
103478
URI
Publication date:
5.6.2013.
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