Clinical Effect Analysis Of The Treatment Of Insertional Achilles Tendinopathy By Cleaning And Reconstruction Of Achilles Tendon

Objective:To analyze the clinical efficacy of the treatment of open insertional Achilles tendinopathy by cleaning and reconstruction of Achilles tendon,and to further clarify the advantages of this surgical method in the treatment of insertional Achilles tendinopathy,so as to provide reference for clinical surgical treatment.Methods:Through the inclusion and exclusion criteria,the relevant information of patients with insertional Achilles tendinopathy treated by Achilles tendon insertion clean-up and reconstruction in the orthopedics Department of the Second Hospital of Shanxi Medical University from November 2020 to December 2021 was collected,and the preoperative and postoperative functional scores of patients were compared: visual analogue scale(VAS),association of foot and ankle surgeons(AOFAS);Complications: satisfaction with symptom improvement,wound healing,anchor loosening,displacement and Achilles tendon rupture;And relevant imaging indicators before operation and at the last follow-up: calcaneal pitch angle(CPA),fowlerand philip angle(FPA),and parallel pitch line(PPL).Results:A total of 29 cases(32 feet)of insertional Achilles tendinopathy were included in this study.In these cases,there are 18 left feet and 14 right feet;17 males(59%)and 12females(41%);The age ranged from 38 to 62 years,with an average of(49.3 ± 7.5)years.All patients received a complete follow-up.During the follow-up period,there was no recurrence of heel pain,swelling,loosening or displacement of anchors,or rupture of the Achilles tendon.The incision healed well,the symptoms improved significantly,and the quality of daily life and work improved significantly.The VAS score decreased from(5.48±1.15)points before surgery to(1.79±1.24)points at 3 months after surgery and(1.48±0.95)points at 6 months after surgery,and the difference was statistically significant(P < 0.01).The AOFAS score increased from(41.1±5.63)points before surgery to(79.79±5.36)points at 3 months after surgery and(89.31±4.63)points at 6months after surgery,with statistically significant differences(P < 0.01).CPA,FPA,and PPL decreased from(17.44±1.41),(71.56±1.39),and 100% before surgery to(15.91±0.78),(48.84±2.59),and 6.25% at the last follow-up,and the differences were statistically significant(P < 0.01).Conclusion:The cleaning and reconstruction of open Achilles tendon insertion can achieve satisfactory short-term clinical results in the treatment of insertional Achilles tendinopathy.This surgical method is convenient for thorough removal of diseased tissue,firm fixation of the Achilles tendon,low incidence of complications,and beneficial for postoperative recovery.It is an effective surgical method for the treatment of insertional Achilles tendinopathy.