Surgical Treatment of the Achilles Insertional Tendinopathy Using the Augmentation with the BT Graft from M. Quadriceps Femoris

PURPOSE OF THE STUDY The aim of the prospective study was to evaluate the effectiveness of the Achilles insertion tendinopathy treatment, focusing on the evaluation of results in patients treated for retrocalcaneal pain, and to review the outcomes following the surgical treatment by means of Achilles tendon reinforcement with the bone-tendon autograft (BT). MATERIAL AND METHODS The group comprised 18 patients, 10 men and 8 women, who were surgically treated with in line with the described surgical protocol. The group was treated at the author s department in the period 2013-2016. The patients were evaluated using the FAOS, VAS, and Kitaoka scores. The diagnosis of the Achilles insertion tendinopathy was confirmed by the MRI examination (changes at the Achilles tendon attachment to the calcaneus). The patients underwent surgery if the pain persisted after the conservative therapy lasting more than half a year. The mean follow-up was 12 months after the surgery. RESULTS The mean FAOS score improved from 4 preoperatively to 1 at the 12-month postoperative follow-up. The mean VAS and Kitaoka score improved from high level of pain preoperatively to low pain level. DISCUSSION Our study evaluated the results of surgical treatment of the diagnosis that may be difficult to treat effectively solely by non-surgical procedures. There are not many studies published in the literature regarding this issue. CONCLUSIONS The method of surgical treatment of the Achilles insertional tendinopathy using the augmentation with the BT graft was found to be an effective procedure with a low risk of complications and reliable results.