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Review
. 2020 Sep 29;13(1):59.
doi: 10.1186/s13047-020-00418-8.

Management of Achilles and patellar tendinopathy: what we know, what we can do

Rocco Aicale  1   2 , Antonio Oliviero  1   2 , Nicola Maffulli  3   4   5   6
Affiliations
Review

Management of Achilles and patellar tendinopathy: what we know, what we can do

Rocco Aicale et al. J Foot Ankle Res. .

Abstract

Tendinopathies are challenging conditions frequent in athletes and in middle-aged overweight patients with no history of increased physical activity. The term "tendinopathy" refers to a clinical condition characterised by pain, swelling, and functional limitations of tendons and nearby structures, the effect of chronic failure of healing response. Tendinopathies give rise to significant morbidity, and, at present, only limited scientifically proven management modalities exist. Achilles and patellar tendons are among the most vulnerable tendons, and among the most frequent lower extremity overuse injuries. Achilles and patellar tendinopathies can be managed primarily conservatively, obtaining good results and clinical outcomes, but, when this approach fails, surgery should be considered. Several surgical procedures have been described for both conditions, and, if performed well, they lead to a relatively high rate of success with few complications. The purpose of this narrative review is to critically examine the recent available scientific literature to provide evidence-based opinions on these two common and troublesome conditions.

Keywords: Achilles Tendinopathy; Arthroscopy; Graft; Patellar tendinopathy; Tendinopathies; Tendon; Tenotomy.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Open surgery for tendinopathy of the main body of the Achilles tendon. The tendinopathic tissue is identified and then excised
Fig. 2
Fig. 2
Autograft reconstruction for chronic Achilles tear. The Flexor hallucis longus tendon graft was harvested through a longitudinal medial incision along the distal portion of the Achilles tendon
Fig. 3
Fig. 3
Minimally invasive percutaneous stripping for chronic Achilles tendinopathy. The 4 small incisions are visible, with the surgical instruments passing through
Fig. 4
Fig. 4
Open surgery for patellar tendinopathy. Excision of the tendinopathic area
Fig. 5
Fig. 5
Open surgery for patellar tendinopathy. The patellar tendon is explored and the tendinopathic areas are excised
See this image and copyright information in PMC

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