Speedbridge re-attachment of the Achilles tendon for insertional tendinopathy

A. Davies, S. Hepple, P. Robinson, V. Sinclair, W. Harries, I. Winson

Aim: Recalcitrant insertional Achilles tendinopathy presents a surgical challenge. Associated Haglund lesions often need removal alongside pathological tendon, which can compromise the integrity of the insertion. The Arthrex Speedbridge is an innovative knotless anchor device, enabling Achilles tendon re-attachment following complete detachment and debridement. The technique has been performed at our Trust since June 2014 for all surgical cases that have failed conservative measures where there is a threat to the Achilles insertion integrity. We present a minimum four month follow-up of the largest patient group currently available in the literature.

Method: All patients treated with Achilles tendon debridement and Speedbridge re-attachment from June 2014-August 2016 were identified. The Manchester-Oxford Foot Questionnaire (MOxFQ) and a satisfaction survey were sent to all patients. All patient correspondence, operative reports, clinic letters and discharge summaries were reviewed. Follow-up telephone interviews were carried out with non-responders.

Results: A total of 38 patients were identified. 29/38 completed the questionnaires (response rate 76%). There were no re-ruptures or wound complications. The mean MOxFQ score was 27.3% and the mean satisfaction score was 9.1/10 (10=very satisfied). 97% would have the procedure again and 66% were working post-surgery. The mean time to return to work was 14 weeks. 34% were playing sport post-fixation, including squash and football.

Conclusion: Detachment, debridement and Speedbridge reattachment is a safe and effective treatment for insertional Achilles tendinopathy with high MOxFQ and satisfaction scores. This paper supports the use of the Arthrex Speedbridge for tendon re-attachment following surgical debridement of Achilles tendinopathy.