Shibuya Naohiro, Thorud Jakob C, Humphers Jon M, Devall J Marshall, Jupiter Daniel C
Texas A&M Health Science Center, College of Medicine, Temple, TX, USA.
J Foot Ankle Surg. 2012 Nov-Dec;51(6):767-71. doi: 10.1053/j.jfas.2012.08.011. Epub 2012 Sep 11.
Insertional Achilles tendinosis results in isolated pain at the Achilles tendon insertion site due to intratendinous degeneration. When conservative measures fail, surgical treatment may be necessary. Radiofrequency coblation has been suggested to be an effective procedure for treatment of tendon pathologies. Percutaneous execution of this procedure is very simple as well as minimally invasive, and thus if effective, would be an excellent alternative to an open treatment of insertional Achilles tendinopathy. A review of 47 cases with this percutaneous technique was conducted. In our relatively short-term follow-up (mean = 8.6 months, SD = 9.71, range 1 to 40), the incidence of reoperation was 14.9% (7/47). Rupture of the Achilles tendon was identified in 3 (6.4%) patients. Our cohort had a relatively high body mass index (mean = 37.1, SD = 6.96, range 24.3 to 52.8). We recommend surgeons to be cautious about selecting this procedure in similar, high body mass index patient cohorts for treatment of Achilles tendinosis.
插入性跟腱病是由于腱内退变导致跟腱附着点处出现孤立性疼痛。当保守治疗无效时，可能需要进行手术治疗。有人提出射频消融术是治疗肌腱病变的一种有效方法。该手术经皮实施非常简单且微创，因此如果有效，将是开放性治疗插入性跟腱病的极佳替代方法。对采用这种经皮技术的47例病例进行了回顾。在我们相对短期的随访中（平均 = 8.6个月，标准差 = 9.71，范围1至40个月），再次手术发生率为14.9%（7/47）。3例（6.4%）患者出现跟腱断裂。我们的队列具有相对较高的体重指数（平均 = 37.1，标准差 = 6.96，范围24.3至52.8）。我们建议外科医生在为体重指数相似的高体重患者群体选择该手术治疗跟腱病时要谨慎。
