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.