Erich Rembeck - Sportorthopädie
Focus List Top-Doctors Knee Surgeon Signage 2018

Focus List Top-Doctors Knee Surgeon Signage 2017
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Diseases of the Ankle Joint
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Chronic Achilles Tendon Partial Tear
Chronic achilles tendon partial tear/ Tenosynovitis/ Tendinitis/ Achillodynia – General information

Many patients with a history of long-lasting pain in the region of the achilles tendon report of the development of pain in phases. Frequently a triggering event is indicated, which was connected with acute pain in the region of the achilles tendon. This pain however declines over time and the normal sport or competition activity can once again be resumed.

After a specific time however, new pain will occur within the region of the tendon. This leads to a short-term immobilisation and a resulting significant improvement of the pain symptoms. The competition activity can then be resumed. This reoccurring procedure frequently occurs over several years and repeats itself over time in ever-shorter time intervals. Often this develops to such an extent, so that light jogging is no longer possible and even long or fast walks cause pain.

The underlying impairment of the tendon is thus the ever-reoccurring tear formation, which through imcomplete healing and reoccurring traumatisation, ultimately lead to an advanced development of scars within the tendon. Due to this, the blood supply to the tendon which increases under pressure, worsens, and the blood supply-related increase in size of the tendon is impaired.

In advanced stages of the disease, a change to the tendon sheaths additionally occurs, which is distinguished through an increasing stiffening of the tendon sheaths. Through this, the size expansion of the tendon is additionally impaired or suspended under pressure.

Depending on the advancement of the disease, a conservative (non-operative) therapy can still be possible. In advanced cases of the illness where even light jogging is generally no longer possible, an operative therapy is frequently unavoidable.

Operative therapy

In cases of chronic achilles tendon damage, the aim of the treatment is the reconstruction of the normal anatomy by cutting the damaged and scarred sections. Regularly through the repeated repair attempts, fibrin exudations (tissue adhesions) lie around the achilles tendon like a too tightly tied coat and restrict, not only the sufficient blood supply, but also the expansion of the tendon under pressure.

Within the scope of the operative procedure, the exudations which encompass the tendon are removed and subsequently the scarred tendon defect of whose localisation and expansion was previously displayed on an MRI scan is found, removed and covered. With this, ensuring appropriate rest of the achilles tendon, it is possible that a new cross-network of the tendon threads develops without the development of a defect scar. Here the aftercare treatment generally occurs in a 0° lower leg cast for 2-3 weeks and subsequently 20kg partial weight-bearing in a lower leg orthosis (Vacuped shoe) for a further 2-4 weeks. The recommencement of the ability to undertake competitions can be strived for at approx. 12 weeks after the operation.

Kontakt zu den Spezialisten der Sport-Orthopädie in München

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Arabellastr. 17
81925 Munich

Tel: +49. 89. 92 333 94-0
Fax : +49. 89. 92 333 94-29

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Dr. Erich H. Rembeck
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