Surgical decompression of chronic central core lesions of the Achilles tendon

We report the outcome of 14 athletes with chronic recalcitrant achillodynia and central core degeneration of the Achilles tendon. The patients underwe nt surgery after an average time from onset of symptoms to surgery of 87 mo nths. All patients had undergone conservative management, including physica l therapy treatment, orthoses, nonsteroidal antiinflammatory drugs, and ste roid injections. At an average follow-up of 35 months (range, 27 to 52), on ly 5 patients had an excellent or good result, despite reexploration in 6 o f the 14 patients. In athletes with long-standing pain and central core deg eneration of the Achilles tendon, prognosis is poor, and even reexploration is not successful. if the referral pattern allows, surgery should probably be undertaken earlier.