Achilles Scraping and Plantaris Tendon Removal Improves Pain and Tendon Structure in Patients with Mid-Portion Achilles Tendinopathy—A 24 Month Follow-Up Case Series

Background: Studies have demonstrated that a sub-group of patients with medial Achilles pain exhibit tendinopathy plantaris tendon involvement. This clinical condition is characterised by structural relationships and functional interference between the two tendons, resulting in compressive or shearing forces. Surgical removal together an scraping procedure has positive short-term results. The aim this case series was to determine long-term outcomes on structure. Methods: 18 consecutive (13 males; 5 females; mean age 39 years; symptom duration 28 months), which three were elites, included. Clinical examination, b-mode ultrasound (US) Ultrasound Tissue Characterisation (UTC) confirmed tenderness, plus located close side tendon. Patients underwent US-guided local followed structured rehabilitation program. Outcomes VISA-A score for function UTC Results: 16 completed 24 months follow-up. Mean scores increased from 58.2 (±15.9) 92.0 (±9.2) (mean difference = 33.8, 95% CI 25.2, 42.8, p < 0.01). There improvement structure organised echo pixels (UTC type I+II, %) increasing 79.9 (±11.5) 86.4 (±10.0) 6.5%, 0.80, 13.80, =0.01), exceeding 3.4% minimum detectable change. All reported satisfaction 14 returned pre-injury activity levels. no complications. Conclusions: Improved pain, observed after treatment excision. indicates compression might be important presenting factor sub-group.