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The American Journal of Sports Medicine 28:634-642 (2000)
© 2000 American Orthopaedic Society for Sports Medicine

Long-Term Prognosis of Patients With Achilles Tendinopathy

An Observational 8-Year Follow-up Study

Mika Paavola, MD*,{dagger},{ddagger},§, Pekka Kannus, MD, PhD{ddagger}, Timo Paakkala, MD, PhD||, Matti Pasanen, MSc{ddagger} and Markku Järvinen, MD, PhD*,{dagger}

* Department of Surgery, Tampere University Hospital, Tampere, Finland
|| Radiology, Tampere University Hospital, Tampere, Finland
{dagger} Medical School and the Institute of Medical Technology, University of Tampere, Tampere, Finland
{ddagger} Accident and Trauma Research Center and the Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland

§ Address correspondence and reprint requests to Mika Paavola, MD, Institute of Medical Technology, POB 607, FIN-33101 Tampere, Finland

To determine the long-term outcome of patients treated nonoperatively for acute or subchronic (duration of the symptoms before initiation of the treatment less than 6 months) Achilles tendinopathy, we performed a follow-up analysis on 83 of 107 patients an average 8 ± 2 (SD) years after the initial contact. The analysis included a questionnaire, clinical examination, performance tests, muscle strength measurement, and ultrasonographic examination. Twenty-four of the 83 patients (29%) had to be operated on during the follow-up period. Seventy patients (84%) had full recovery of their activity level, and at 8 years’ follow-up 78 patients (94%) were asymptomatic or had only mild pain with strenuous exercise. However, a clear side-to-side difference between the involved and the uninvolved sides was observed on the performance test, clinical examination, and ultrasonography. Also, 34 patients (41%) started to suffer from overuse symptoms in the initially uninvolved Achilles tendon. The results of our 8-year follow-up showed that the long-term prognosis of patients with acute-to-subchronic Achilles tendinopathy is favorable as determined by subjective and functional assessments. In the clinical and ultrasonographic examinations, mild-to-moderate changes were observed rather frequently in both the involved and initially uninvolved Achilles tendons, but the occurrence of these changes was not clearly related to the patients’ symptoms.




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