Tendón de Aquiles anatomía e insuficiencia

Achilles tendon anatomy and insufficiency

Introducción: mediante la revisión del tema apoyada en los textos clásicos y la literatura actual, se formulan los principales aspectos de la insuficiencia del tendón de Aquiles para adquirir diferentes herramientas conceptuales y terapéuticas en la práctica clínica. Metodología: los motores de búsqueda utilizados fueron PubMed, Clinical Key, Embase, Cochrane y Lilacs, se incluyeron referencias en español e inglés, publicadas entre 1980 y 2020. Los artículos se revisaron utilizando CONSORT, STROBE o PRISMA, según el caso. Resultados: fueron seleccionados 30 artículos, entre ellos metanálisis, revisiones sistemáticas, estudios prospectivos, observacionales y revisiones narrativas. Discusión: existe un amplio espectro de factores de riesgo para la insuficiencia, intrínsecos y extrínsecos, que la predisponen, aunque la etiología sigue siendo incierta. Para las tendinopatías en general el tratamiento de elección es la rehabilitación realizada por personal capacitado, reservando el abordaje quirúrgico para los casos donde el manejo conservador es fallido, mediante técnicas quirúrgicas de liberación percutánea o abiertas. El tratamiento no quirúrgico de las rupturas ha mostrado excelentes resultados siempre que esté sujeto a un estricto proceso de rehabilitación desde el momento del diagnóstico. Conclusión: esta revisión aporta conceptos básicos y su correlación con la biomecánica, indispensables para el diagnóstico temprano y el tratamiento favorable. 

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