Our Summary

The paper discusses Achilles tendinopathy, a common injury that affects the foot and ankle, often caused by overuse. This condition, characterized by pain, swelling, and reduced performance, can be categorized into two types based on where it occurs in the body: insertional and noninsertional tendinopathy.

There are many factors that contribute to Achilles tendinopathy, including both internal (intrinsic) and external (extrinsic) ones. The condition occurs when the body’s healing response fails and degenerative changes appear in the tendon.

This healing failure happens in three continuous stages: reactive tendinopathy (the body’s initial response to injury), tendon disrepair (when the body attempts to heal the injury but fails), and degenerative tendinopathy (long-term damage to the tendon).

Scientific studies have shown that these conditions result in an increased number of tenocytes (tendon cells), higher concentration of a substance called glycosaminoglycans, disorder and fragmentation of a protein called collagen, and the growth of new blood vessels.

Treatment for Achilles tendinopathy varies and can include both non-surgical and surgical options. However, there is no universally accepted best treatment method due to differing results in various studies. The paper calls for more high-quality research to help determine the most effective treatment options for this condition.

FAQs

  1. What is Achilles tendinopathy and how is it classified?
  2. What are the factors contributing to the etiology of Achilles tendinopathy?
  3. What are the different treatment options for Achilles tendinopathy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tendon repair is to follow a comprehensive rehabilitation program that includes specific exercises to strengthen the tendon and surrounding muscles, as well as stretching to improve flexibility. It is important to gradually increase intensity and duration of exercises to avoid re-injury. Additionally, maintaining a healthy lifestyle with proper nutrition and hydration can support the healing process. It is also important to follow any post-operative instructions provided by the doctor and attend follow-up appointments for monitoring progress.

Suitable For

Patients who are typically recommended tendon repair are those with Achilles tendinopathy, a common overuse injury characterized by pain, swelling, and impaired performance in the ankle and foot. This condition can be classified into insertional and noninsertional tendinopathy, with multifactorial causes including intrinsic and extrinsic factors. Patients with failed healing response and degenerative changes in the tendon, as seen in histological studies, may benefit from tendon repair surgery. However, the effectiveness of conservative and surgical treatment options for Achilles tendinopathy remains controversial, highlighting the need for further research to establish a gold standard of care for these patients.

Timeline

Before tendon repair:

  1. Patient experiences pain, swelling, and impaired performance in the affected tendon.
  2. Patient may try conservative treatments such as rest, ice, physical therapy, and orthotics.
  3. If conservative treatments fail to improve symptoms, patient may consider surgical options for tendon repair.

After tendon repair:

  1. Patient undergoes surgery to repair the damaged tendon.
  2. Patient undergoes post-operative rehabilitation to regain strength and function in the repaired tendon.
  3. Patient gradually resumes normal activities under the guidance of healthcare providers.
  4. Patient may experience pain, stiffness, and weakness in the repaired tendon during the recovery process.
  5. Patient gradually improves over time with proper rehabilitation and follow-up care.

What to Ask Your Doctor

  1. What type of tendon repair surgery do you recommend for my specific condition?
  2. What are the risks and potential complications associated with tendon repair surgery?
  3. What is the expected recovery time after tendon repair surgery?
  4. What type of rehabilitation program will I need to follow after surgery?
  5. What are the long-term outcomes and success rates of tendon repair surgery?
  6. Are there any alternative treatments or therapies that could be beneficial for my tendon injury?
  7. How can I prevent future tendon injuries or re-injury after surgery?
  8. Will I need any additional follow-up appointments or monitoring after tendon repair surgery?
  9. Are there any lifestyle changes or modifications that I should make to support my healing and recovery process?
  10. What are the signs and symptoms of potential complications or problems that I should watch for after surgery?

Reference

Authors: Li HY, Hua YH. Journal: Biomed Res Int. 2016;2016:6492597. doi: 10.1155/2016/6492597. Epub 2016 Nov 3. PMID: 27885357