M. Paavola et al., Long-term prognosis of patients with Achilles tendinopathy - An observational 8-year follow-up study, AM J SP MED, 28(5), 2000, pp. 634-642
To determine the long-term outcome of patients treated nonoperatively for a
cute or subchronic (duration of the symptoms before initiation of the treat
ment less than 6 months) Achilles tendinopathy, we performed a follow-up an
alysis on 83 of 107 patients an average 8 +/- 2 (SD) years after the initia
l contact. The analysis included a questionnaire, clinical examination, per
formance tests, muscle strength measurement, and ultrasonographic examinati
on. Twenty-four of the 83 patients (29%) had to be operated on during the f
ollow-up period. Seventy patients (84%) had full recovery of their activity
level, and at 8 years' follow-up 78 patients (94%) were asymptomatic or ha
d only mild pain with strenuous exercise. However, a clear side-to-side dif
ference between the involved and the uninvolved sides was observed on the p
erformance test, clinical examination, and ultrasonography. Also, 34 patien
ts (41%) started to suffer from overuse symptoms in the initially uninvolve
d 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 Ac
hilles tendons, but the occurrence of these changes was not clearly related
to the patients' symptoms.