Tendo-Achilles tendinosis and rupture Flashcards
What is tendon-achilles tendinosis?
This is the chronic degradation of the Achilles tendon
What causes tendo-Achilles tendinosis?
This is caused by repetetive microtrauma, with failure of collagen repair with loss of fibre alignement
Where is the most common region for tendinosis and rupture of the Achilles tendon?
2-6cm superior to the attachment to the calcaneous, as this is a hypo-vascular region
What are some factors that can increase risk of tendo-Achilles tendinosis?
Ciprofloxacin
Steroids
How will tendo-Achilles tendinosis present?
- Pain
- Morning stiffness
- Eases with heat or walking
How is diagnosis of tendo-Achilles tendinosis made?
Clinical examination
Possible USS and MRI
How will tendo-Achilles tendinosis be managed?
- Activity modification
- Analgesia
- NSAIDs
- Shockwave therapy
- Orthotics
- Physiotherapy
- Surgery
Who is most at risk of Achilles tendon rupture?
Patients over 40
Those with pre-existing tendinosis
What is a possible, acute cause of Achilles tendon rupture?
Sudden deceleration with resisted calf contraction
How will Achilles tendon rupture present?
- Sudden intense pain (Someone has hit them in the ankle)
- Unable to bear weight
- Weak plantar flexion
- Palpable painful gap
- Positive calf squeeze (Simmonds) test
How is Achilles tendon rupture treated?
Both conservative and surgical management, both with the same extended recovery time and functional outcome
