Classification and arthroscopic surgery of chronic achilles tendinitis

Abstract

To investigate the clinical classification of chronic achilles tendinitis and analyze the surgical technique and efficacy of arthroscopic surgery. Twenty-two patients (16 males, 6 females) with chronic achilles tendinitis were recruited. The average age was 33.5 years old (range: 17 - 53). Sixteen cases were caused by sport injury while 6 cases had no definite etiological factor. The Achilles tendinopathy was divided into three types according to clinical characteristics and the results of X ray, CT scan and MRI examination of ankle: Type 1, hypertrophy (n = 10); Type 2, calcified tubercle (n = 5); Type 3, fiber tear (n = 7). All cases were treated with endoscopic debridement of ventral neovascularized area, peritendineum and Achilles tendon by shaver and radiofrequency (RF) probe. The patients were followed-up for a mean of 14 months (range: 9 - 15). Evaluated by our criteria and visual analogue scale, the post-operative efficacy was excellent in 12 cases, good in 8 and fair in 2. No postoperative complications, such as neurovascular injury, infection and rupture of Achilles tendon, was recorded. This scheme of classifying is helpful to the diagnosis and effective treatment of chronic Achilles tendonitis. With a high safety and a satisfactory efficacy, arthroscopic surgery has the advantages of minimally invasiveness.