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手术治疗的跟腱止点性肌腱病翻修手术的结果

Outcomes of Revision surgery for surgically treated insertional Achilles tendinopathy.

作者信息

Hörterer Hubert, Oppelt Sonia, Pfahl Kathrin, Harrasser Norbert, Böcker Wolfgang, Polzer Hans, Walther Markus, Baumbach Sebastian Felix

机构信息

Center for Foot and Ankle Surgery, Schön Klinik München Harlaching, Munich, Germany.

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center, Munich (MUM), University Hospital, LMU Munich, Munich, Germany.

出版信息

Arch Orthop Trauma Surg. 2024 Dec 16;145(1):52. doi: 10.1007/s00402-024-05693-9.

DOI:10.1007/s00402-024-05693-9
PMID:39680218
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11649710/
Abstract

INTRODUCTION

There is a clear roadmap for the treatment of primary insertional Achilles tendinopathy (IAT), but data on the outcome of revision surgery is missing. The current study aimed to analyze the outcome following revision surgery for surgically failed IAT.

MATERIAL AND METHODS

Included were patients with IAT revision surgery at a single reference center (01/2010-10/2016) and a follow-up of at least 12 months. Revision surgery was performed, whenever possible, through a midline incision transachillary approach (MITA) with debridement of all pathologies present. The patient-rated outcome was assessed per the FFI (preoperative, final follow-up) and VISA-A-G (final follow-up). The aim was to evaluate the patient rated outcome following revision surgery for recurrent IAT.

RESULTS

Out of 24 eligible patients, 19 (79%) were included in the final follow-up. The mean follow-up duration was 4.6 ± 2.2 years. The FFI Overall improved from preoperatively 68 ± 19 to 14 ± 17 points (< 0.001) at the final follow-up. The final VISA-A-G was 71 ± 28 points. 39%/36% (FFI/VISA-A-G) of patients reached patient-rated outcome scores comparable to a healthy reference population. No factors could be identified to influence the outcome significantly.

CONCLUSION

IAT revision surgery results in an improvement of the patients' symptoms, but only one-third of the patients recover fully.

摘要

引言

对于原发性跟腱附着点病（IAT）的治疗有明确的路线图，但关于翻修手术结果的数据却缺失。本研究旨在分析手术失败的IAT翻修手术后的结果。

材料与方法

纳入在单一参考中心接受IAT翻修手术（2010年1月至2016年10月）且随访至少12个月的患者。只要有可能，翻修手术通过经腋窝中线切口入路（MITA）进行，并清除所有存在的病变。根据FFI（术前、最终随访）和VISA - A - G（最终随访）评估患者自评结果。目的是评估复发性IAT翻修手术后患者的自评结果。

结果

24例符合条件的患者中，19例（79%）纳入最终随访。平均随访时间为4.6±2.2年。最终随访时，FFI总分从术前的68±19分改善至14±17分（<0.001）。最终的VISA - A - G评分为71±

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a34/11649710/73fe8908430c/402_2024_5693_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a34/11649710/ccb3b2a1353e/402_2024_5693_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a34/11649710/73fe8908430c/402_2024_5693_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a34/11649710/ccb3b2a1353e/402_2024_5693_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a34/11649710/73fe8908430c/402_2024_5693_Fig2_HTML.jpg

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Foot Ankle Int. 2023 Aug;44(8):702-709. doi: 10.1177/10711007231173679. Epub 2023 Jun 4.
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