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* Department of Orthopaedic Surgery, University of Aberdeen Medical School, Aberdeen, Scotland
Department of Orthopaedic Surgery, Warwick General Hospital, Warwick
Department of Sports Medicine, The London Hospital Medical College, Mile End Hospital, London, England
Address correspondence and reprint requests to Nicola Maffulli, MD, MS, PhD, FRCS(Orth), Department of Orthopaedic Surgery, University of Aberdeen Medical School, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, Scotland
We report the outcome of 14 athletes with chronic recalcitrant achillodynia and central core degeneration of the Achilles tendon. The patients underwent surgery after an average time from onset of symptoms to surgery of 87 months. All patients had undergone conservative management, including physical therapy treatment, orthoses, nonsteroidal antiinflammatory drugs, and steroid injections. At an average follow-up of 35 months (range, 27 to 52), only 5 patients had an excellent or good result, despite reexploration in 6 of the 14 patients. In athletes with long-standing pain and central core degeneration of the Achilles tendon, prognosis is poor, and even reexploration is not successful. If the referral pattern allows, surgery should probably be undertaken earlier.
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