Achilles Tendon: Tendinopathy and Ruptures

Publication Date

1-1-2026

Document Type

Article

Publication Title

Foot and Ankle Disorders an Illustrated Reference

Abstract

The Achilles tendon is known as the largest and strongest tendon in the body; however, it is also the most commonly injured tendon especially in young athletes and in some aging individuals.Achilles tendinopathy, whether an Achilles tendinosis or an Achilles tendinitis, can occur during sports activity or even in ordinary activity of daily living. We recommend eccentric loading exercise and ESWT with silicon heel cup, NSAID medication, and restriction of overactivity as baseline treatments.There is no clinical and ultrasonographic evidence of superiority with PRP injection over a placebo injection in chronic Achilles tendinosis at 1 year combined with an eccentric training program. More research on the effects of PRP and stem cell injection in Achilles tendon should be performed in the future.Most of the acute Achilles tendon (AT) rupture occurs during sports activity which accounts to 35% of all tendon injuries. Simple end-to-end repair is carried out using either the Kessler or Krackow technique. Mini-open indirect repair and percutaneous repair along with nonoperative treatment are also widely performed.The choice between operative and nonoperative management in patients with chronic AT ruptures will depend on the overall health status of the patient, the assessment of risk factors for healing, and the patient’s level of activity.As for surgical treatment of chronic AT ruptures, V-Y advancement, FHL transfer, and allograft tendon transfer are preferred options.

First Page

455

Last Page

492

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