Moonot Pradeep, Dakhode Shubham
Mumbai Knee Foot Ankle Clinic, Mumbai, India.
J Clin Orthop Trauma. 2024 Feb 23;50:102374. doi: 10.1016/j.jcot.2024.102374. eCollection 2024 Mar.
Achilles tendinopathy is a common overuse injury affecting the ankle and foot. It manifests as a clinical condition that includes pain, edema, and decreased functionality. This condition can be broadly categorized into two main types based on anatomical location: insertional and noninsertional tendinopathy. The development of Achilles tendinopathy involves various factors, both internal and external. Patients with Achilles tendinopathy often experience stiffness worsened by prolonged rest, and pain exacerbated by physical activity. These symptoms can limit work activity and sports participation, with many patients facing discomfort while wearing shoes due to heel sensitivity. Diagnosis is primarily clinical, although MRI and ultrasound imaging can aid in differential diagnosis. Identifying risk factors and understanding the patient's biomechanics assist in accurate diagnosis and subsequent management. Management of Achilles tendinopathy involves a range of conservative and surgical options. However, due to varying results in clinical studies, a definitive gold standard treatment has not emerged. Eccentric exercises are a valuable tool in managing the condition. The recommend treatments such as shock wave therapy or nitric oxide patches are sought if symptoms do not improve. Peritendinous injections could be options if physical therapy proves ineffective. Surgical intervention is required after six months of conservative treatment. Recent research on Achilles tendinopathy emphasizes the need for individualized treatment plans that address its multifaceted nature. Combining biomechanical analysis, advanced imaging, and patient-specific factors is key to achieving optimal outcomes. Additionally, preventive strategies focusing on proper training techniques, load management, and addressing modifiable risk factors play a critical role in reducing the incidence of this condition. In conclusion, this article provides a current overview of Achilles tendinopathy. It highlights the importance of a comprehensive approach to understanding its causes, pathophysiology, diagnosis, and management strategies.
跟腱病是一种常见的过度使用损伤，影响踝关节和足部。它表现为一种临床病症，包括疼痛、水肿和功能下降。根据解剖位置，这种病症可大致分为两种主要类型：插入性和非插入性跟腱病。跟腱病的发生涉及多种内部和外部因素。跟腱病患者常常会经历长时间休息后僵硬加剧，以及身体活动时疼痛加剧的情况。这些症状会限制工作活动和体育参与，许多患者因足跟敏感而在穿鞋时感到不适。诊断主要依靠临床症状，不过磁共振成像（MRI）和超声成像有助于鉴别诊断。识别风险因素并了解患者的生物力学情况有助于准确诊断及后续治疗。跟腱病的治疗包括一系列保守和手术选择。然而，由于临床研究结果各异，尚未出现明确的金标准治疗方法。离心运动是治疗该病的一种有效手段。如果症状没有改善，可以采用冲击波疗法或一氧化氮贴片等推荐治疗方法。如果物理治疗无效，腱鞘内注射可能是一种选择。保守治疗六个月后需要进行手术干预。最近关于跟腱病的研究强调需要制定个性化的治疗方案，以应对其多方面的性质。结合生物力学分析、先进成像技术和患者特定因素是实现最佳治疗效果的关键。此外，注重正确训练技巧、负荷管理以及解决可改变的风险因素的预防策略在降低该病发病率方面起着至关重要的作用。总之，本文提供了跟腱病的当前概述。它强调了采用综合方法来理解其病因、病理生理学、诊断和管理策略的重要性。
