Achilles tendon anatomy and insufficiency

Tendón de Aquiles anatomía e insuficiencia

Introduction: the main aspects of Achilles tendon (AT) insufficiency were determined through the review of classic texts and current literature on the topic, to acquire the various conceptual and therapeutic tools in clinical practice. Methodology: we used the PubMed, Clinical Key, Embase, Cochrane and Lilacs search engines, including references in Spanish and English published between 1980 and 2020. Articles were reviewed using the CONSORT, STROBE or PRISMA guidelines, as appropriate. Results: 30 articles directly related to the topic were selected. Meta-analyses, systematic reviews, prospective and observational studies, and narrative reviews were included. Discussion: there is a wide spectrum of intrinsic and extrinsic predisposing risk factors for the development of AT insufficiency, but its etiology remains unclear.  The mainstay treatment for tendinopathies in general, is rehabilitation provided by trained personnel. The surgical approach, by percutaneous or open surgical release techniques, is reserved for cases in which conservative approaches fail. Nonsurgical treatment for ruptured AT has shown excellent outcomes if patients undergo a strict rehabilitation process following diagnosis, however, in our socioeconomic context, tendon repair surgery continues to be a first-line therapeutic pillar. Conclusion: this review provides basic concepts and their correlation with biomechanics, indispensable for an early diagnosis and successful treatment.

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