Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 30;16(1):233.
doi: 10.1186/s13018-021-02370-0.

Nonoperative treatment of insertional Achilles tendinopathy: a systematic review

Xiaosong Zhi #  1 , Xinyuan Liu #  2 , Jing Han  1 , Yang Xiang  3 , Helin Wu  4 , Shijun Wei  5   6 , Feng Xu  7   8
Affiliations

Nonoperative treatment of insertional Achilles tendinopathy: a systematic review

Xiaosong Zhi et al. J Orthop Surg Res. .

Abstract

Background: Insertional Achilles tendinopathy is difficult to manage, and there is no definite consensus on which nonoperative treatment is superior over the others. We aim to provide a clear summary of the best available evidence for nonoperative treatment specific to insertional Achilles tendinopathy.

Methods: Literatures were searched in PubMed, Embase, and Web of Science databases from inception to October 2020. The results were evaluated independently by two reviewers and assessed against the inclusion/exclusion criteria. All included articles were assessed for methodological quality, and study characteristics were extracted.

Results: Twenty-three studies (containing 35 groups) were eligible for the final review. The treatments included eccentric training, extracorporeal shockwave therapy (ESWT), injections, and combined treatment. Visual analog scale (VAS), Victorian Institute of Sport Assessment-Achilles questionnaire, AOFAS, satisfaction rate, and other scales were used to assess the clinical outcome.

Conclusion: Current evidence for nonoperative treatment specific for insertional Achilles tendinopathy favors ESWT or the combined treatment of ESWT plus eccentric exercises.

Keywords: Insertional Achilles tendinopathy; Nonoperative treatment; Systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Flowchart of the literature selection
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. van Dijk CN, van Sterkenburg MN, Wiegerinck JI, Karlsson J, Maffulli N. Terminology for Achilles tendon related disorders. Knee Surg Sports Traumatol Arthrosc. 2011;19(5):835–841. doi: 10.1007/s00167-010-1374-z. - DOI - PMC - PubMed
    1. Chimenti RL, Cychosz CC, Hall MM, Phisitkul P. Current concepts review update: insertional Achilles tendinopathy. Foot Ankle Int. 2017;38(10):1160–1169. doi: 10.1177/1071100717723127. - DOI - PMC - PubMed
    1. Maffulli N, D'Addona A, Gougoulias N, Oliva F, Maffulli GD. Dorsally based closing wedge osteotomy of the calcaneus for insertional Achilles tendinopathy. Orthop J Sports Med. 2020;8(3):2325967120907985. doi: 10.1177/2325967120907985. - DOI - PMC - PubMed
    1. Giai Via A, Oliva F, Padulo J, Oliva G, Maffulli N. Insertional calcific tendinopathy of the Achilles tendon and dysmetabolic diseases: an epidemiological survey. Clin J Sport Med. 2020Publish Ahead of Print. 10.1097/JSM.0000000000000881. - PubMed
    1. Clain MR, Baxter DE. Achilles tendinitis. Foot Ankle. 1992;13(8):482–487. doi: 10.1177/107110079201300810. - DOI - PubMed

Publication types