Division for Foot and Ankle Surgery, Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Nussbaumstrasse 20, 80336, München, Germany.
Center for Foot and Ankle Surgery, Schön Klinik München Harlaching, Harlachinger Strasse 51, 81547, Munich, Germany.
Arch Orthop Trauma Surg. 2022 Nov;142(11):3045-3052. doi: 10.1007/s00402-021-03897-x. Epub 2021 Apr 23.
Diagnosis and treatment of insertional tendinopathy of the Achilles tendon (IAT) remains a challenge. The aim of this study was to assess the influence of pre-operative radiological pathologies on the patient-reported outcomes following open debridement of all pathologies for IAT.
In this IRB-approved retrospective correlation and comparative study, patients with pre-operative imaging were identified from the authors' retrospective IAT database comprising of 118 patients. All were treated by a standardized surgical treatment strategy utilizing a midline, transachillary approach and debridement of all pathologies. A total of fifteen radiologic parameters were measured on radiographs (RX) and MRI. The patient-reported outcomes were assessed using the Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A-G) and the general health questionnaire SF-12 at a minimum follow-up of 12 months. The data are presented as mean ± SD (95% CI).
88 patients (74.6%) with an average age of 50 ± 12 (47-52) years were included. Radiographs were available in 68 patients and MRI in 53. The mean follow-up was 3.8 ± 1.9 (3.4-4.3) years. The overall VISA-A-G was 81 ± 22 (77-86), the SF-12 PCS 54 ± 7 (52-55), and the SF-12 MCS 52 ± 9 (50-54) points. None of the assessed radiological parameters had a significant influence on the patient-reported outcome following surgical treatment for IAT.
In this retrospective correlation study, no significant association was found between preoperative radiographic and MRI radiologic parameters for IAT and postoperative patient-reported outcomes (VISA-A-G and SF-12).
跟腱止点腱病（IAT）的诊断和治疗仍然是一个挑战。本研究的目的是评估术前影像学病变对所有病变行开放性清创术治疗 IAT 后的患者报告结局的影响。
在这项经机构审查委员会批准的回顾性相关性和对照研究中，作者从他们的回顾性 IAT 数据库中确定了有术前影像学资料的患者，该数据库包含 118 例患者。所有患者均采用标准化手术治疗策略进行治疗，即通过中线、经跟腱入路，对所有病变进行清创。在 X 线片（RX）和 MRI 上共测量了 15 个影像学参数。使用维多利亚运动评估-跟腱问卷（VISA-A-G）和一般健康问卷 SF-12 在至少 12 个月的随访时评估患者报告的结局。数据以平均值±标准差（95%置信区间）表示。
共纳入 88 例（74.6%）患者，平均年龄 50±12 岁（47-52 岁）。68 例患者有 RX 资料，53 例患者有 MRI 资料。平均随访时间为 3.8±1.9 年（3.4-4.3 年）。总体 VISA-A-G 为 81±22 分（77-86），SF-12 PCS 为 54±7 分（52-55），SF-12 MCS 为 52±9 分（50-54）。没有一个评估的影像学参数与 IAT 手术治疗后的患者报告结局（VISA-A-G 和 SF-12）有显著相关性。
在这项回顾性相关性研究中，IAT 的术前放射影像学和 MRI 影像学参数与术后患者报告结局（VISA-A-G 和 SF-12）之间没有显著关联。
