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Achilles peritendinitis: endoscopic or open tenolysis?
ESSKA Academy. Canata G. Nov 8, 2019; 284350; epAFAS-14 Topic: Ankle
Dr. Gian Luigi Canata
Dr. Gian Luigi Canata
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Achilles peritendinitis: endoscopic or open tenolysis?

ePoster - epAFAS-14

Topic: Tendons

Canata G.L., Casale V.
Koelliker Hospital, Centre of Sport Traumatology, Torino, Italy

Achilles tendinopathies are common in athletes. In literature, the terms peritendinitis, tendinosis and tendonitis have been widely used, without a certain clinical rationale to differentiate each histopathological entity. The term peritendinitis usually indicate an inflammation of the peritendinous sheaths, without any pathological changes in the tendon itself.
Surgery is indicated after a failed conservative treatment and consists in releasing the underlying tendon by removing adhesions and scar tissues.
We compared functional results after an arthroscopic or an open Achilles tenolysis for treating Achilles peritendinitis refractory to conservative treatment.
The aim of this study is to identify the most effective surgical approach.
9 patients, mean age 57 years (r. 42-75), 8 males and 1 female, undergoing Achilles tenolysis were divided into two groups. In group A (5 patients, 4 males and 1 female) the tenolysis was performed arthroscopically. In group B (4 patients, all men) an open technique was used.
The mean follow-up was 6 years (r. 0,5-14).
The pre- and postopeartive evaluation used methods were the American Orthopedic Foot and Ankle Score (AOFAS), the Victorian Institute of Sports Assessment for Achilles tendon (VISA-A), the Visual Analogue Scale (VAS) score and the Tegner score. Statistic analysis performed with Student t test.
Group A: mean preoperative Tegner score 5.6 (SD 0.9), postoperative 4.4 (SD 1.3). Mean preoperative AOFAS score 30.6 (SD 19.6), postoperative 87.4 (SD 20.5). Mean preoperative VISA-A score 17.8 (SD 9), postoperative 70.8 (SD 24.3). Mean preoperative VAS score 8.6 (SD 0.9), postoperative 1 (SD 1.3).
Group B: mean preoperative Tegner score 6.3 (SD 1), postoperative 6 (SD 1.2). Mean preoperative AOFAS score 38.5 (SD 27.6), postoperative 100 (SD 0). Mean preoperative VISA-A score 29 (SD 14.3), postoperative 99 (SD 2). Mean preoperative VAS score 8 (SD 2.2), postoperative 0 (SD 0).
In both groups, one patient quit sport for other reasons.
The mean time to return to sport was 4 months after the endoscopic approach and 6 months after the open technique.
The statistical analysis showed no significant differences (p >0.05) between the two groups in postoperative functional results with the Student t test.
Compared to the open access procedure, the endoscopic technique for treating Achilles peritendinitis offers the advantage similar results, less invasiveness, low morbidity without postoperative complications.
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