Long-term prognosis of patients with Achilles tendinopathy - An observational 8-year follow-up study

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.