Tripler Army Medical Center, Honolulu, Hawaii.
Foot Ankle Spec. 2023 Aug;16(4):342-348. doi: 10.1177/19386400211029121. Epub 2021 Oct 23.
A retrospective review of consecutive patients diagnosed with insertional Achilles tendinopathy (IAT) was performed. Outcomes included Visual Analog Scale (VAS) pain scores, return to run rates, and return to military duty rates. Our data analysis included 113 patients; 58 (55%) patients required surgery. Mean duration of follow-up was 42 months (range, 12-143). Mean age at the time of surgery was 37.2 years (range, 21-54). VAS scores significantly improved from 5.4 at the preoperative visit to 2.9 at 24 months. There was no significant improvement in VAS scores after the 3-month postoperative visit. Mean return to run time was 9 months (range, 4.5-16). At 1 year, 80% (46/58) of patients returned to military duty. Complications requiring return to the operating room were observed in 6 patients (9%). The high rate of return to duty and significant improvement in pain scores demonstrate that the surgical management of IAT is a viable treatment option for patients who could not otherwise remain on active duty. With that said, the complication rate of 27% is high. Patients and providers should consider the risks, benefits, and duration of therapy during their shared decision-making process. Level IV.
回顾性分析了连续诊断为插入性跟腱病（IAT）的患者。结果包括视觉模拟量表（VAS）疼痛评分、恢复跑步率和恢复兵役率。我们的数据分析包括 113 名患者；58 名（55%）患者需要手术。平均随访时间为 42 个月（范围 12-143）。手术时的平均年龄为 37.2 岁（范围 21-54）。VAS 评分从术前的 5.4 显著改善到 24 个月时的 2.9。术后 3 个月时 VAS 评分无明显改善。平均恢复跑步时间为 9 个月（范围 4.5-16）。1 年后，80%（46/58）的患者恢复兵役。有 6 名患者（9%）因需要返回手术室而出现并发症。高的复职率和疼痛评分的显著改善表明，对于无法继续现役的患者，IAT 的手术治疗是一种可行的治疗选择。话虽如此，27%的并发症发生率还是很高的。患者和提供者在共同决策过程中应考虑风险、益处和治疗持续时间。IV 级。
