Achilles Tendinopathies and Rupture

Alice A. Deden, MD and Amy Davis, MD Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Spectrum of disorders involving Achilles tendon, paratenon, and retrocalcaneal bursa

  • Painful inflammation of Achilles tendon and its sheath due to chronic degenerative tendinosis and ...

DIAGNOSIS

HISTORY

  • Tendinopathy

    • Pain, swelling, warmth along tendon

    • Noninsertional most common

    • Pain exacerbated by activity, relief with rest

  • Peritonitis—localized burning pain accompanies/follows activit...

TREATMENT

GENERAL MEASURES

  • Tendinopathy

    • Ice, nonsteroidal anti-inflammatory drugs (NSAIDs), rest (LOE: C)

    • Heel lift, orthotics, appropriate footwear (LOE: C)

    • Eccentric exercise (LOE: A)

    • Correct training ...

ONGOING CARE

FOLLOWUP RECOMMENDATIONS

Routine follow-up until resolution of symptoms 

MONITORING

Achilles Tendon Total Rupture Score is the only validated outcome measure. 

PATIENT TEACHING

  • Adherence to re...

REFERENCES

Zhang H, Tang H, He Q et al. Surgical versus conservative intervention for acute Achilles tendon rupture: a PRISMA-compliant systematic review of overlapping meta-analyses. Medicine (Balti...

ADDITIONAL READING

  • Beyer R, Kongsgaard M, Hougs Kjær B et al. Heavy slow resistance versus eccentric training as treatment for Achilles tendinopathy: a randomized controlled trial. Am J Sports Med. &#...

CODES

ICD10

  • M76.60 Achilles tendinitis, unspecified leg

  • S86.009A Unspecified injury of unspecified Achilles tendon, initial encounter

  • S86.019A Strain of unspecified Achilles tendon, initial encounter

  • S86....

PEARLS

  • Achilles rupture can generally be diagnosed clinically; ultrasound is useful to confirm if there is uncertainty

  • ~20% of acute Achilles tears become chronic.

  • Optimal treatment of complete rupture ...

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