The mainstay of treatment in non-insertional Achilles tendinopathy is non-operative, however between 1/4 and 1/3 of patients fail this. The main symptom is pain which appears to be related to new nerve endings that grow into the tendon with the neovessels from the paratenon. Treatments which strip the paratenon from the tendon are showing promise including formal paratenon stripping via Achilles tendinoscopy. The pain and swelling in Achilles tendinopathy is usually on the medial side leading to the postulation that the plantaris tendon may have a role to play. We report a consecutive series of 11 patients who underwent Achilles tendinoscopy with stripping of the paratenon and division of the plantaris tendon, above the level of the tendinopathic changes in the Achilles. All patients had failed conservative treatment for at least 6 months and requested surgical intervention. The patients were scored with the SF-36, AOS and AOFAS hindfoot questionnaires pre-operatively and at a minimum of 2 years post operatively. They also recorded their level of satisfaction with the treatment at final follow up.Introduction
Methods
In recent years, the plantaris tendon has been
implicated in the development of chronic painful mid-portion Achilles tendinopathy.
In some cases, a thickened plantaris tendon is closely associated
with the Achilles tendon, and surgical excision of the plantaris
tendon has been reported to be curative in patients who have not
derived benefit following conservative treatment and surgical interventions. The aim of this review is to outline the basic aspects of, and
the recent research findings, related to the plantaris tendon, covering
anatomical and clinical studies including those dealing with histology,
imaging and treatment. Cite this article
Background. The
