Achillestendinopathy Treated With Proximal Medial Gastrocnemius Recession

Launched by OSTFOLD HOSPITAL TRUST · Dec 16, 2021

Keywords

ClinConnect Summary

This clinical trial is studying a surgical procedure called Proximal Medial Gastrocnemius Recession, aimed at treating chronic pain in the Achilles tendon, specifically for patients with a condition known as Chronic Mid-Portion Achilles Tendinopathy. The trial will follow 60 patients over five years to see how well this surgery helps relieve their pain and improve their ability to walk and be active.

To be eligible for this study, participants must be between 18 and 75 years old and have been experiencing pain in the middle part of their Achilles tendon for at least a year. They should also have tried physical therapy without finding relief. A doctor will need to confirm their condition through a physical exam and an MRI, which is a special scan that shows detailed images of the tendon. Patients who have had previous serious injuries or surgeries on their Achilles tendon, or other significant health issues, may not qualify. Those who participate can expect to have their progress monitored for five years after the surgery, providing valuable information about the long-term benefits of this treatment.

Gender

ALL

Eligibility criteria

• Inclusion criteria:
• • 1. Age 18-75 years.
• • 2. Diagnosis CMPAT verified clinically by orthopedic surgeon. Symptoms must include mid-portion pain in the Achilles, swelling and reduced tolerance for weightbearing.
• • 3. Verified diagnosis with MRI findings representing pathologic processes of tendon degeneration and repair (13). MRI no older than 12 months.
• • 4. Duration of symptoms must be at least 12 months.
• • 5. Isolated gastrocnemius tightness must be verified with the Silfverskiölds test before inclusion. The Silfverskiöld test is considered positive if ankle dorsiflexion is restricted to 5 degrees or less with the knee extended, and there is an increase of ankle dorsiflexion of at least 10 degrees when flexing the knee.
• • 6. At least three months of conventional physical therapy with eccentric training must have been tried without providing relief of symptoms.
• Exclusion criteria:
• • 1. Previous history of complete Achilles tendon rupture.
• • 2. Other combined pathologies in the Achilles tendon of calf (Sequela from trauma, infections, cancer etc.).
• • 3. Insertional Achilles tendinopathy.
• • 4. Previously undergone surgery in affected tendon.
• • 5. Patients with severe talocrural pathology or serious malalignment of foot and ankle.
• • 6. Severely reduced peripheral circulation.
• • 7. History of alcoholism, drug abuse, psychological or other emotional problems likely to jeopardize informed consent.
• • 8. Patients with a contraindication/non-compliance for MRI examination.
• • 9. History of allergic reaction/anaphylactic reaction to local anesthetics.
• • 10. Not able to read and/or speak a Scandinavian language or English adequately.
• • 11. Other serious comorbidity that makes surgery unadvisable.