Surgical treatment of Achilles tendinitis by decompression of the retrocalcaneal bursa and the superior calcaneal tuberosity
Surgical treatment of Achilles tendinitis by decompression of the retrocalcaneal bursa and the superior calcaneal tuberosity
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DOI：
10.1177/03635465020300030301
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发表时间：
2002-05-01
影响因子：
4.8
通讯作者：
Minos, L
中科院分区：
文献类型：
--
作者：
Yodlowski, ML;Scheller, AD;Minos, L
背景：跟腱疼痛（通常称为“肌腱炎”）的初始非手术治疗并不总是成功。假设：手术治疗对于非手术措施未能缓解的插入性肌腱炎患者有效。研究设计：回顾性队列研究。方法：对 35 名患有跟腱疼痛综合征且经过 6 个月的非手术措施未能缓解的患者（41 英尺）进行了手术治疗。该技术包括沿着跟腱外侧缘的单个切口。解剖暴露了跟后滑囊和脂肪垫，连同任何疤痕和增厚的腱旁都被完全切除。进行了结节部分跟骨外骨切除术。 结果：在至少 20 个月（平均 39）的随访中，患者的疼痛评分（评分从 0 到 6）从术前的 4.7（SD，1.1）改善到 1.5（SD，1.3）； 90% 的症状完全或显着缓解，10% 感觉有所改善，没有人感觉没有变化或更严重。结论：手术治疗慢性跟腱疼痛，包括切除突出的结节、完全清创滑囊、切除增厚、有疤痕的腱旁，以及去除肌腱内可触及的钙化沉积物，是一种有效的治疗方法。
Background: Initial nonoperative treatment of pain at the Achilles tendon, often referred to as "tendinitis," is not always successful.Hypothesis: Surgical treatment is effective for patients with insertional tendinitis unrelieved by nonoperative measures.Study Design: Retrospective cohort study.Methods: Thirty-five patients (41 feet) who had painful Achilles tendon syndrome unrelieved by 6 months of nonoperative measures were treated surgically. The technique consisted of a single incision along the lateral border of the Achilles tendon. The dissection exposed the retrocalcaneal bursa and fat pad, which were completely excised along with any scarred and thickened paratenon. A partial calcaneal exostectomy of the tubercle was performed.Results: At a minimum follow-up of 20 months (average, 39), the patients' pain scores (rated from 0 to 6) improved from 4.7 (SD, 1.1) preoperatively to 1.5 (SD, 1.3); 90% had complete or significant relief of symptoms, 10% felt improved, and none felt unchanged or worse.Conclusions: Surgical treatment of chronic Achilles tendon pain with resection of the prominent tuberosity, complete debridement of the bursa, excision of thickened, scarred paratenon, and removal of accessible calcific deposits within the tendon is an effective treatment.