The long-term outcome of tendon lengthening for chronic Achilles tendon pain.

Abstract

The purpose of this study was to assess the long-term results of tendon lengthening surgery for the treatment of chronic Achilles tendon pain. The results of 21 procedures in 18 patients were assessed. Each patient had an open Z-plasty to lengthen the Achilles tendon by 1 cm. Results showed a long-term (7.5 years) reduction in visual analogue pain scores for sporting activity in 20 of 21 procedures (median 50 point reduction, p < 0.0005). The tendon lengthening was apparent in a mean increase in dorsiflexion of 5 degrees. Two patients had minor gait abnormalities postoperatively. One patient had a reduction in plantarflexion power on the operated side, but five patients had improved power compared to the nonoperated limb. One major and five minor surgical complications were noted. The retrospective nature of this study must be noted in drawing conclusions. However, the results suggest excellent long-term reduction of Achilles pain after tendon lengthening. This must be weighed against a relatively high complication rate for any procedure in this region. This treatment does not appear to cause long-term deficits in plantarflexion power or gait.