Outcomes of Revision surgery for surgically treated insertional Achilles tendinopathy

There is a clear roadmap for the treatment of primary insertional Achilles tendinopathy (IAT), but data on the outcome of revision surgery is missing. The current study aimed to analyze the outcome following revision surgery for surgically failed IAT.

Included were patients with IAT revision surgery at a single reference center (01/2010–10/2016) and a follow-up of at least 12 months. Revision surgery was performed, whenever possible, through a midline incision transachillary approach (MITA) with debridement of all pathologies present. The patient-rated outcome was assessed per the FFI (preoperative, final follow-up) and VISA-A-G (final follow-up). The aim was to evaluate the patient rated outcome following revision surgery for recurrent IAT.

Out of 24 eligible patients, 19 (79%) were included in the final follow-up. The mean follow-up duration was 4.6 ± 2.2 years. The FFI Overall improved from preoperatively 68 ± 19 to 14 ± 17 points (< 0.001) at the final follow-up. The final VISA-A-G was 71 ± 28 points. 39%/36% (FFI/VISA-A-G) of patients reached patient-rated outcome scores comparable to a healthy reference population. No factors could be identified to influence the outcome significantly.

IAT revision surgery results in an improvement of the patients’ symptoms, but only one-third of the patients recover fully.