Achilles Tendon Repair
Achilles tendon, is most commonly injured in sports, and therefore, there has been an increasing incidence of injuries of the tendon over the past decade, particularly in the more developed countries.
To avoid confusing terminology referring to Achille tendon injuries, the clinical syndrome in the tendon characterized by pain, swelling and impaired ability to perform certain movements or activities has been generically called Achilles tendinopathy (55-65% of injury cases).
Specialists have identified two main sources of tendinopathies: loading-induced degeneration, caused by overuse (strenuous physical activities, running, jumping) and systemic, predisposing diseases, such as rheumatoid arthritis (only 2% of cases).
Among the factors that predispose a person to these problems, there are a few intrinsic risk factors – “lower extremity malalignments, leg length discrepancy, muscle weakness and imbalance, decreased flexibility, and overweight” (Jarvinen et al.) and several extrinsic factors, such as excessive loading of the body and training errors.
There are many treatment options for tendinopathies described in the literature, mostly nonoperative; initial phases can be corrected with the help of orthotics, to correct malalignments, complete rest of the ankle joint, nonsteroidal anti-inflammatory drugs, corticosteroid injections around the Achilles tendon (used with precaution) and specific exercise protocols. Most patients with tendinopathies have responded favourably to conservative treatment, and only a clear failure of such treatment indicates that surgery is necessary.
Ruptures are spontaneous, complete tears of the Achille tendon. Generally, no symptoms are present before the rupture; however, histopathologic studies have shown tissue degeneration at and around the rupture site. It was concluded that sedentary lifestyle, leading to poor local blood circulation and sudden or repetitive movements (usually occurring in sports) lead to Achille tendon ruptures.
There are three main types of treatment of Achille tendon ruptures: the open operative method, the percutaneous operative method and nonoperative options.