18th April - Achilles and peroneal tendons

Venue - Wrightington starting 2pm

Leader - Mr T Clough

Topic - Achilles and peroneal (+/- FHL) tendon problems

Aiming to cover:

  • Achilles tendonopathy
  • Achilles tendon rupture
  • Peroneal tendonopathy
  • Peroneal instability
  • FHL if possible - however, our guest speaker, Prof Bill Ribbans, is ill and can’t come. We’re not having much luck with guest speakers - once again, we’ll try to fit his talk in later in the module

Achilles tendon

The new Hyperbook pages on Achilles tendonopathy and Achilles rupture are finally on the site! Sorry about the delay, partly technical. Some of them still need a bit of work over the next few days, but at least they are up to date and in the new mainly-HTML format. There is quite a lot of new literature since the previous edition, so please try to have a look at the new pages before the session.

Can I also remind you that all the near-real-time updates to the Hyperbook have left some inconsistencies in the navigation. If you seem to end up on the wrong page or an out-of-date version try going through the homepage - as far as I know all the links there are up to date.

Suggested reading

Khan, RJ, Fick, D, et al. (2005). Treatment of acute achilles tendon ruptures. A meta-analysis of randomized, controlled trials. J Bone Joint Surg Am 87(10): 2202-10

Suchak, AA, Spooner, C, et al. (2006). Postoperative rehabilitation protocols for Achilles tendon ruptures: a meta-analysis. Clin Orthop Relat Res 445: 216-21

Cretnik, A, Kosanovic, M, et al. (2005). Percutaneous versus open repair of the ruptured Achilles tendon: a comparative study. Am J Sports Med 33(9): 1369-79

Alfredson H, Cook J. A treatment algorithm for managing Achilles tendonopathy: new treatment options. Br J Sports Med 2007; 41:211-6

Ortmann, FW and McBryde, AM (2007). Endoscopic bony and soft-tissue decompression of the retrocalcaneal space for the treatment of Haglund deformity and retrocalcaneal bursitis. Foot Ankle Int 28(2): 149-53

Rompe JD et al. Eccentric loading compared with shock wave treatment for chronic insertional achilles tendinopathy. A randomized, controlled trial.J Bone Joint Surg Am. 2008 Jan;90(1):52-61.

Peroneal tendonopathy and instability

The Hyperbook section has been recently updated.

Good recent review in JBJS - if you read this you should be covered for the exam:

Heckman DS et al. Operative treatment for peroneal tendon disorders. JBJS 2008; 90A:404-18

Let me know if you want anything more detailed. The references page for the Hyperbook will appear in a bit.

FHL

Now recognised as a cause of posterior ankle pain and medial foot pain, especially in athletes and dancers whose activities involve a lot of equinus. No Hyperbook chapter as yet (opportunity?…) If you can get it this is a good article:

Michelson J, Dunn L. Tenosynovitis of the flexor hallucis longus: a clinical study of the spectrum of presentation and treatment. Foot Ankle Int 2005; 26:291-303