Vega Jordi, Cabestany Josep Maria, Golanó Pau, Pérez-Carro Luis
Department of Orthopedic and Trauma Surgery, Hospital Asepeyo Sant Cugat, Barcelona, Spain.
Foot Ankle Surg. 2008;14(4):204-10. doi: 10.1016/j.fas.2008.02.005. Epub 2008 Jun 2.
This study presents our experience and results in patients with Achilles tendinopathy treated with an endoscopic technique.
Eight patients with chronic tendinopathy of the Achilles underwent endoscopic treatment. A distal portal is created 2 cm proximal of the lateral margin of the tendon insertion. A slotted cannula is inserted in a proximal direction and toward the midline. A 4.5 mm diameter arthroscope is advanced through the cannula. An additional portal, equidistant to the lateral portal, can be created at the medial distal level if we need to access the most medial and distal part of the tendon. Pathological tissue is eliminated while performing multiple longitudinal tenotomies with a retrograde knife blade. Clinical outcome was assessed according to the Nelen scale.
Clinical results were scored as excellent, with all patients able to return to pre-procedure sports activity without limitations. There were no complications in any case.
Endoscopic treatment yielded satisfactory results with lower morbidity than other reported techniques.
本研究介绍了我们使用内镜技术治疗跟腱病患者的经验和结果。
8例慢性跟腱病患者接受了内镜治疗。在跟腱附着点外侧边缘近端2 cm处建立一个远端入路。将带槽套管向近端并朝向中线插入。将直径4.5 mm的关节镜通过套管推进。如果需要进入跟腱最内侧和远端部分，可在内侧远端水平创建一个与外侧入路等距的额外入路。使用逆行刀片进行多次纵向腱切断术时清除病理组织。根据Nelen量表评估临床结果。
临床结果评为优秀，所有患者均能不受限制地恢复术前体育活动。无一例出现并发症。
与其他报道的技术相比，内镜治疗取得了满意的结果，发病率更低。
