Kipp Jennifer A, Blazek Cody D
Department of Orthopaedic Surgery and Rehabilitation, Atrium Health Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA.
Department of Vascular and Endovascular Surgery, Atrium Health Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA.
J Clin Med. 2025 Jul 4;14(13):4736. doi: 10.3390/jcm14134736.
: Achilles tendon pathologies, such as Achilles tendinitis, tendinosis, ruptures, and equinus contracture, cause pain and functional impairment. While surgical intervention is indicated in some cases, many patients are successfully managed with nonoperative treatment. The goal of this review was to evaluate the current evidence-based treatments for the nonoperative management of Achilles tendon disorders, focusing on indications and clinical outcomes. A scoping review of the literature was conducted from 2015 to 2025 from the PubMed database. Research published in the last ten years was included if it addressed nonoperative treatments for Achilles tendinopathy, acute ruptures, and/or equinus contracture. The outcome measures of interest included functional outcomes, re-rupture rates, and overall patient satisfaction. Nonoperative management results in favorable outcomes for a wide range of Achilles tendon pathologies. Eccentric loading is supported for chronic tendinopathy, and functional rehabilitation programs with early mobilization have shown comparable outcomes to surgical repair for acute tendon ruptures. Combination therapy for the nonoperative management of equinus is favored. These therapies include stretching protocols, casting, and the botulinum toxin. The literature supports the notion that nonoperative management strategies for Achilles tendon pathologies provide symptom relief and functional improvement in patients. However, these treatment plans should be individualized and tailored to patient-specific goals.
跟腱病变，如跟腱炎、肌腱病、断裂和马蹄足挛缩，会引起疼痛和功能障碍。虽然在某些情况下需要手术干预，但许多患者通过非手术治疗成功得到了管理。本综述的目的是评估目前基于证据的跟腱疾病非手术治疗方法，重点关注适应证和临床结果。从2015年到2025年在PubMed数据库中对文献进行了范围综述。如果研究涉及跟腱病、急性断裂和/或马蹄足挛缩的非手术治疗，则纳入过去十年发表的研究。感兴趣的结局指标包括功能结局、再断裂率和患者总体满意度。非手术治疗对多种跟腱病变都能产生良好的效果。对于慢性肌腱病，支持进行离心负荷训练，对于急性肌腱断裂，早期活动的功能康复计划已显示出与手术修复相当的效果。马蹄足非手术治疗倾向于联合治疗。这些疗法包括拉伸方案、石膏固定和肉毒杆菌毒素。文献支持这样一种观点，即跟腱病变的非手术治疗策略能为患者缓解症状并改善功能。然而，这些治疗方案应根据患者的具体目标进行个体化定制。
