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Achilles tendinopathy can be improved with gastrocnemius recession

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CHICAGO — Gastrocnemius recession can be helpful in some cases for the treatment of patients with chronic Achilles tendinopathy, according to a presenter here.

Benedict F. DiGiovanni

“We believe the outcomes from this study provide some new information regarding ankle muscle power and endurance and may be used to help guide selection of appropriate candidates for this procedure,” Benedict F. DiGiovanni, MD, said during his presentation at the International Federation of Foot & Ankle Societies Triennial Meeting.

DiGiovanni and colleagues studied eight patients with chronic unilateral Achilles tendinopathy and an isolated gastrocnemius contracture participated. All patients underwent gastrocnemius recession, and final follow-up occurred at 6 months postoperatively. Foot kinematics and muscle function during gait, stair ascent (standard and high-step) and single-limb heel raises were determined via electromagnetic tracking device and force plate data. Changes at final follow-up regarding the affected ankle, side-to-side muscle power and endurance, pain and self-reported function were also evaluated.

Deficits between preoperative and final follow-up were observed in the affected ankle power during standard-step (2.5 and 2.2 W/kg, respectively; a 10% deficit) and high-step ascent (4.1 and 3.1 W/kg, respectively; a 24% deficit). A 21% deficit was also seen in endurance during repeated single-limb heel raises.

A 26% deficit was observed in side-to-side plantarflexion power decrease at final follow-up during high-step ascent, the most significant area of decline, according to DiGiovanni.
Self-reported pain and function values for both activities of daily life and sport improved at 6-month follow-up (Daily life: 75% to 90%; Sport: 40% to 69%).

“Longer-term follow-up [in future studies] may show improvement in power and endurance,” DiGiovanni said. — by Christian Ingram

Reference: DiGiovanni BF. A prospective analysis of biomechanical foot function following an isolated gastrocnemius recession for achilles tendinopathy. Presented at: International Federation of Foot & Ankle Societies Triennial Meeting; Sept. 19-21, 2014; Chicago.

Disclosure: DiGiovanni has no relevant financial disclosures.