Clinical outcomes following surgical management of insertional Achilles tendinopathy using a double row suture bridge technique with mean two year follow up

T.L Lewis, T. Srirangarajan, A. Patel, G.CK Yip, L. Hussain, R. Walker, S. Singh, A. Latif, A. Abbasian

Background: The clinical outcomes following surgical management of insertional achilles tendinopathy (IAT) vary depending on the surgical technique used to reattach the achilles tendon following debridement. The aim of this study was to investigate the clinical outcomes of patients with IAT who underwent surgical management with a double row suture bridge technique used to reattach the achilles tendon.

Methods: A retrospective review of consecutive patients diagnosed with IAT, who underwent surgical management utilising a double row suture bridge technique (Arthex Speedbridge) and a minimum of 3-month follow up were included. The primary outcome was the Manchester- Oxford Foot Questionnaire (MOXFQ) Index score which is a patient reported outcome measure (PROM). Secondary outcomes included EuroQol EQ-5D-5L health-related quality of life PROM and complication rates.

Results: Between July 2013 and June 2020, 50 consecutive patients (23 male; 27 female) were included. The mean age (± standard deviation) was 52.3±11.3 (range 29.0-84.3). Pre- and post-operative PROM data was available for all cases. The mean follow up was 2.4±1.9 years. The MOXFQ Index score improved from 48.5 to 12.4 (p<0.01), EQ-5D-5L improved from 2.7±0.46 to 1.2±0.37 (p<0.01), and EQ-VAS improved from 48.0±18.4 to 84.1±12.6 (p<0.01). 6 patients had complications, of which 4 were of minimal clinical relevance and caused no deviation from routine recovery. There were no cases of tendon rupture.

Conclusion: This study has demonstrated that surgical management of IAT is safe and effective with clinical improvement in both clinical and general health-related quality of life outcome PROMs.