Schepsis A A, Wagner C, Leach R E
Department of Orthopaedic Surgery, Boston University Medical Center/University Hospital, Massachusetts.
Am J Sports Med. 1994 Sep-Oct;22(5):611-9. doi: 10.1177/036354659402200508.
We studied 79 cases of surgically treated Achilles tendon overuse injuries in 66 patients. Fifty-three (80%) of these patients were competitive or serious recreational runners operated on between 1978 and 1991. There were 49 men and 17 women with a mean age of 33 years (range, 17 to 59). The cases were divided into surgical subgroups based on their site of primary symptoms and abnormalities: paratenonitis (23), tendinosis (partial rupture or degeneration) (15), retrocalcaneal bursitis (24), insertional tendinitis (7), and combined abnormalities (10). Followup included a comprehensive patient questionnaire and office examination. There were 79% satisfactory (51% excellent, 28% good) and 21% unsatisfactory (17% fair, 4% poor) results. The percentages of satisfactory results in the paratenonitis group (87%) were best and those in the tendinosis group were the worst (67%). Satisfactory results were obtained in 75% of the patients with retrocalcaneal bursitis and 86% with insertional tendinitis. Seven of the 45 cases with longer than 5-year followup with initially satisfactory results deteriorated with time and required reoperation (16%). Of these, 4 were in the tendinosis group, 2 had retrocalcaneal bursitis, and 1 had paratenonitis. One of the 34 patients followed less than 5 years required reoperation.
我们研究了66例接受手术治疗的跟腱过度使用损伤患者的79个病例。其中53例（80%）患者为竞技或重度休闲跑步者，于1978年至1991年间接受手术。有49名男性和17名女性，平均年龄33岁（范围17至59岁）。这些病例根据主要症状和异常部位分为手术亚组：腱周炎（23例）、肌腱病（部分断裂或退变）（15例）、跟腱后滑囊炎（24例）、止点性腱鞘炎（7例）和合并异常（10例）。随访包括一份全面的患者问卷和门诊检查。结果为满意的占79%（优51%，良28%），不满意的占21%（中17%，差4%）。腱周炎组满意结果的百分比最高（87%），肌腱病组最差（67%）。跟腱后滑囊炎患者中75%获得满意结果，止点性腱鞘炎患者中86%获得满意结果。45例随访时间超过5年且最初结果满意的病例中，有7例随时间推移病情恶化，需要再次手术（16%）。其中，4例在肌腱病组，2例患有跟腱后滑囊炎，1例患有腱周炎。34例随访时间不足5年的患者中有1例需要再次手术。
