Maffulli Nicola, Oliva Francesco, Maffulli Gayle D, Giai Via Alessio, Gougoulias Nikolaos
Professor, Department of Musculoskeletal Disorders, Faculty of Medicine, University of Salerno, Salerno, Italy; Professor, Queen Mary University of London, Barts, United Kingdom; Professor, The London School of Medicine and Dentistry, William Harvey Research Institute, Centre for Sports and Exercise Medicine, Mile End Hospital, London, United Kingdom.
Orthopedist, Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy.
J Foot Ankle Surg. 2017 Sep-Oct;56(5):938-942. doi: 10.1053/j.jfas.2017.05.019. Epub 2017 Jun 26.
Achilles tendinopathy is a common cause of disability. New nerves fibers grow from the paratenon into the Achilles tendon, and they could play a central role in the development of pain. We report the results of minimally invasive Achilles tendon stripping for Achilles tendinopathy in 47 active patients. The Victorian Institute of Sports Assessment-Achilles questionnaire score improved from 53.8 preoperatively to 85.3 postoperatively (p < .001). After a mean follow-up period of 40.5 months, 41 patients had resumed sporting activities at an average of 3.5 months postoperatively. A sural nerve injury was recorded in 5 patients (10.6%), and all 5 complications occurred during the first 12 cases. As a result, the technique was slightly modified, and no sural nerve neuropathy was observed subsequently. One superficial infection (2.1%) was recorded. Minimally invasive Achilles tendon stripping seems to be an effective, technically simple, and inexpensive treatment of Achilles tendinopathy. Further randomized controlled trials involving more patients are needed to confirm these outcomes.
跟腱病是导致残疾的常见原因。新的神经纤维从腱周膜长入跟腱,它们可能在疼痛的发生发展中起核心作用。我们报告了47例活动期患者接受微创跟腱剥离术治疗跟腱病的结果。维多利亚运动评估-跟腱问卷评分从术前的53.8提高到术后的85.3(p <.001)。平均随访40.5个月后,41例患者在术后平均3.5个月恢复了体育活动。记录到5例(10.6%)出现腓肠神经损伤,且所有5例并发症均发生在前12例手术中。因此,对该技术进行了轻微改良,随后未观察到腓肠神经病变。记录到1例浅表感染(2.1%)。微创跟腱剥离术似乎是一种治疗跟腱病的有效、技术简单且成本低廉的方法。需要开展更多涉及更多患者的随机对照试验来证实这些结果。