CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(06): 657-664
DOI: 10.1055/s-0040-1702953
Artigo de Atualização
Pé e tornozelo

Lesões do Aquiles – Parte 1: Tendinopatias

Article in several languages: português | English
1   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
1   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
1   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
2   Departamento de Ortopedia e Traumatologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
,
1   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
1   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
› Author Affiliations

Resumo

As afecções que acometem o tendão calcâneo são extremamente comuns na população geral e no cotidiano da atenção ortopédica. Sua crescente incidência, motivada pelo envelhecimento da população, pela melhora no acesso à saúde, pelo aumento na utilização de drogas de uso contínuo, pela errática participação esportiva e outros fatores, tem causado impacto direto na sociedade. As tendinopatias, ainda que hoje respaldadas por tratamentos consolidados, carecem de suporte científico de qualidade para muitas das suas recomendações. Novas terapêuticas têm surgido com o objetivo de potencializar o resultado da abordagem não-operatória e diminuir a quantidade de pacientes que necessitam de uma cirurgia. Esses procedimentos operatórios apresentam uma boa resposta álgica e funcional dos pacientes, no entanto não são livres de complicações e dos altos custos que os cercam.



Publication History

Received: 10 September 2019

Accepted: 29 November 2019

Article published online:
29 April 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referências

  • 1 Cohen JC. Anatomy and biomechanical aspects of the gastrocsoleus complex. Foot Ankle Clin 2009; 14 (04) 617-626
  • 2 Doral MN, Alam M, Bozkurt M. et al. Functional anatomy of the Achilles tendon. Knee Surg Sports Traumatol Arthrosc 2010; 18 (05) 638-643
  • 3 Dalmau-Pastor M, Fargues-Polo Jr B, Casanova-Martínez Jr D, Vega J, Golanó P. Anatomy of the triceps surae: a pictorial essay. Foot Ankle Clin 2014; 19 (04) 603-635
  • 4 Longo UG, Ronga M, Maffulli N. Achilles tendinopathy. Sports Med Arthrosc Rev 2009; 17 (02) 112-126
  • 5 Shaw HM, Vázquez OT, McGonagle D, Bydder G, Santer RM, Benjamin M. Development of the human Achilles tendon enthesis organ. J Anat 2008; 213 (06) 718-724
  • 6 Maffulli N, Barrass V, Ewen SWB. Light microscopic histology of achilles tendon ruptures. A comparison with unruptured tendons. Am J Sports Med 2000; 28 (06) 857-863
  • 7 Bernstein DN, Anderson MR, Baumhauer JF. et al. A Comparative Analysis of Clinical Outcomes in Noninsertional Versus Insertional Tendinopathy Using PROMIS. Foot Ankle Spec 2018; 12 (04) 350-356
  • 8 Roche AJ, Calder JD. Achilles tendinopathy: A review of the current concepts of treatment. Bone Joint J 2013; 95-B (10) 1299-1307
  • 9 Magnan B, Bondi M, Pierantoni S, Samaila E. The pathogenesis of Achilles tendinopathy: a systematic review. Foot Ankle Surg 2014; 20 (03) 154-159
  • 10 Chimenti RL, Cychosz CC, Hall MM, Phisitkul P. Current Concepts Review Update: Insertional Achilles Tendinopathy. Foot Ankle Int 2017; 38 (10) 1160-1169
  • 11 Vieira CP, Guerra FR, Oliveira LP, Almeida MS, Pimentel ER. Alterações no tendão de Aquiles após inflamação em tecido adjacente. Acta Ortop Bras 2012; 20 (05) 266-269
  • 12 Magra M, Maffulli N. Genetic aspects of tendinopathy. J Sci Med Sport 2008; 11 (03) 243-247
  • 13 Ribbans WJ, Collins M. Pathology of the tendo Achillis: do our genes contribute?. Bone Joint J 2013; 95-B (03) 305-313
  • 14 van der Vlist AC, Breda SJ, Oei EHG, Verhaar JAN, de Vos RJ. Clinical risk factors for Achilles tendinopathy: a systematic review. Br J Sports Med 2019; pii: bjsports-2018-099991
  • 15 Marie I, Delafenêtre H, Massy N, Thuillez C, Noblet C. Network of the French Pharmacovigilance Centers. Tendinous disorders attributed to statins: a study on ninety-six spontaneous reports in the period 1990-2005 and review of the literature. Arthritis Rheum 2008; 59 (03) 367-372
  • 16 de Jonge S, van den Berg C, de Vos RJ. et al. Incidence of midportion Achilles tendinopathy in the general population. Br J Sports Med 2011; 45 (13) 1026-1028
  • 17 Yelland MJ, Sweeting KR, Lyftogt JA, Ng SK, Scuffham PA, Evans KA. Prolotherapy injections and eccentric loading exercises for painful Achilles tendinosis: a randomised trial. Br J Sports Med 2011; 45 (05) 421-428
  • 18 Baltes TPA, Zwiers R, Wiegerinck JI, van Dijk CN. Surgical treatment for midportion Achilles tendinopathy: a systematic review. Knee Surg Sports Traumatol Arthrosc 2017; 25 (06) 1817-1838
  • 19 Singh A, Calafi A, Diefenbach C, Kreulen C, Giza E. Noninsertional Tendinopathy of the Achilles. Foot Ankle Clin 2017; 22 (04) 745-760
  • 20 Maffulli N, Via AG, Oliva F. Chronic Achilles Tendon Disorders: Tendinopathy and Chronic Rupture. Clin Sports Med 2015; 34 (04) 607-624
  • 21 Hoffmann A, Mamisch N, Buck FM, Espinosa N, Pfirrmann CWA, Zanetti M. Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with Achilles tendon abnormalities. Eur Radiol 2011; 21 (09) 1996-2003
  • 22 Fischer MA, Pfirrmann CWA, Espinosa N, Raptis DA, Buck FM. Dixon-based MRI for assessment of muscle-fat content in phantoms, healthy volunteers and patients with achillodynia: comparison to visual assessment of calf muscle quality. Eur Radiol 2014; 24 (06) 1366-1375
  • 23 Alfredson H, Pietilä T, Jonsson P, Lorentzon R. Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. Am J Sports Med 1998; 26 (03) 360-366
  • 24 Sussmilch-Leitch SP, Collins NJ, Bialocerkowski AE, Warden SJ, Crossley KM. Physical therapies for Achilles tendinopathy: systematic review and meta-analysis. J Foot Ankle Res 2012; 5 (01) 15
  • 25 Alfredson H. Clinical commentary of the evolution of the treatment for chronic painful mid-portion Achilles tendinopathy. Braz J Phys Ther 2015; 19 (05) 429-432
  • 26 Silbernagel KG, Thomeé R, Thomeé P, Karlsson J. Eccentric overload training for patients with chronic Achilles tendon pain--a randomised controlled study with reliability testing of the evaluation methods. Scand J Med Sci Sports 2001; 11 (04) 197-206
  • 27 de Jonge S, de Vos RJ, Weir A. et al. One-year follow-up of platelet-rich plasma treatment in chronic Achilles tendinopathy: a double-blind randomized placebo-controlled trial. Am J Sports Med 2011; 39 (08) 1623-1629
  • 28 Alfredson H, Öhberg L. Sclerosing injections to areas of neo-vascularisation reduce pain in chronic Achilles tendinopathy: a double-blind randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 2005; 13 (04) 338-344
  • 29 Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet 2010; 376 (9754): 1751-1767
  • 30 Costa ML, Shepstone L, Donell ST, Thomas TL. Shock wave therapy for chronic Achilles tendon pain: a randomized placebo-controlled trial. Clin Orthop Relat Res 2005; 440 (440) 199-204
  • 31 Korakakis V, Whiteley R, Tzavara A, Malliaropoulos N. The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction. Br J Sports Med 2018; 52 (06) 387-407
  • 32 Zwiers R, Wiegerinck JI, van Dijk CN. Treatment of midportion Achilles tendinopathy: an evidence-based overview. Knee Surg Sports Traumatol Arthrosc 2016; 24 (07) 2103-2111
  • 33 Tallon C, Coleman BD, Khan KM, Maffulli N. Outcome of surgery for chronic Achilles tendinopathy. A critical review. Am J Sports Med 2001; 29 (03) 315-320
  • 34 Kolodziej P, Glisson RR, Nunley JA. Risk of avulsion of the Achilles tendon after partial excision for treatment of insertional tendonitis and Haglund's deformity: a biomechanical study. Foot Ankle Int 1999; 20 (07) 433-437
  • 35 Nunley JA, Ruskin G, Horst F. Long-term clinical outcomes following the central incision technique for insertional Achilles tendinopathy. Foot Ankle Int 2011; 32 (09) 850-855
  • 36 Rahm S, Spross C, Gerber F, Farshad M, Buck FM, Espinosa N. Operative treatment of chronic irreparable Achilles tendon ruptures with large flexor hallucis longus tendon transfers. Foot Ankle Int 2013; 34 (08) 1100-1110
  • 37 Pearce CJ, Carmichael J, Calder JD. Achilles tendinoscopy and plantaris tendon release and division in the treatment of non-insertional Achilles tendinopathy. Foot Ankle Surg 2012; 18 (02) 124-127
  • 38 van Sterkenburg MN, Kerkhoffs GM, van Dijk CN. Good outcome after stripping the plantaris tendon in patients with chronic mid-portion Achilles tendinopathy. Knee Surg Sports Traumatol Arthrosc 2011; 19 (08) 1362-1366
  • 39 Duthon VB, Lübbeke A, Duc SR, Stern R, Assal M. Noninsertional Achilles tendinopathy treated with gastrocnemius lengthening. Foot Ankle Int 2011; 32 (04) 375-379
  • 40 Maffulli N, Oliva F, Testa V, Capasso G, Del Buono A. Multiple percutaneous longitudinal tenotomies for chronic Achilles tendinopathy in runners: a long-term study. Am J Sports Med 2013; 41 (09) 2151-2157
  • 41 Longo UG, Ramamurthy C, Denaro V, Maffulli N. Minimally invasive stripping for chronic Achilles tendinopathy. Disabil Rehabil 2008; 30 (20-22): 1709-1713
  • 42 Amin NH, McCullough KC, Mills GL, Jones MH. The Impact and Functional Outcomes of Achilles Tendon Pathology in National Basketball Association Players. Clin Res Foot Ankle 2016; 4 (03) 205
  • 43 Hutchison A-M, Laing H, Williams P, Bodger O, Topliss C. The effects of a new Tendo-Achilles Pathway (TAP) on an orthopaedic department- A quality improvement study. Musculoskelet Sci Pract 2019; 39: 67-72
  • 44 Waldecker U, Hofmann G, Drewitz S. Epidemiologic investigation of 1394 feet: coincidence of hindfoot malalignment and Achilles tendon disorders. Foot Ankle Surg 2012; 18 (02) 119-123
  • 45 Den Hartog BD. Insertional Achilles tendinosis: pathogenesis and treatment. Foot Ankle Clin 2009; 14 (04) 639-650
  • 46 Kearney R, Costa ML, Tr F. Insertional achilles tendinopathy management: a systematic review. Foot Ankle Int 2010; 31 (08) 689-694
  • 47 Stenson JF, Reb CW, Daniel JN, Saini SS, Albana MF. Predicting Failure of Nonoperative Treatment for Insertional Achilles Tendinosis. Foot Ankle Spec 2018; 11 (03) 252-255
  • 48 Krishna Sayana M, Maffulli N. Insertional Achilles tendinopathy. Foot Ankle Clin 2005; 10 (02) 309-320
  • 49 Jonsson P, Alfredson H, Sunding K, Fahlström M, Cook J. New regimen for eccentric calf-muscle training in patients with chronic insertional Achilles tendinopathy: results of a pilot study. Br J Sports Med 2008; 42 (09) 746-749
  • 50 Fahlström M, Jonsson P, Lorentzon R, Alfredson H. Chronic Achilles tendon pain treated with eccentric calf-muscle training. Knee Surg Sports Traumatol Arthrosc 2003; 11 (05) 327-333
  • 51 Kearney RS, Costa ML. Collagen-matrix allograft augmentation of bilateral rupture of the achilles tendon. Foot Ankle Int 2010; 31 (06) 556-559
  • 52 Notarnicola A, Moretti B. The biological effects of extracorporeal shock wave therapy (eswt) on tendon tissue. Muscles Ligaments Tendons J 2012; 2 (01) 33-37
  • 53 Wang CJ. Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res 2012; 7 (01) 11
  • 54 Kertzman P, Lenza M, Pedrinelli A, Ejnisman B. Shockwave treatment for musculoskeletal diseases and bone consolidation: qualitative analysis of the literature. Rev Bras Ortop 2015; 50 (01) 3-8
  • 55 Furia JP. [Extracorporeal shockwave therapy in the treatment of chronic insertional Achilles tendinopathy]. Orthopade 2005; 34 (06) 571-578
  • 56 Rompe JD, Furia J, Maffulli N. Eccentric loading compared with shock wave treatment for chronic insertional achilles tendinopathy. A randomized, controlled trial. J Bone Joint Surg Am 2008; 90 (01) 52-61
  • 57 Rasmussen S, Christensen M, Mathiesen I, Simonson O. Shockwave therapy for chronic Achilles tendinopathy: a double-blind, randomized clinical trial of efficacy. Acta Orthop 2008; 79 (02) 249-256
  • 58 Mansur NSB, Baumfeld T, Villalon F. et al. Shockwave Therapy Associated With Eccentric Strengthening for Achilles Insertional Tendinopathy: A Prospective Study. Foot Ankle Spec 2019; •••: 1938640019826673
  • 59 Al-Abbad H, Simon JV. The effectiveness of extracorporeal shock wave therapy on chronic achilles tendinopathy: a systematic review. Foot Ankle Int 2013; 34 (01) 33-41
  • 60 Mani-Babu S, Morrissey D, Waugh C, Screen H, Barton C. The effectiveness of extracorporeal shock wave therapy in lower limb tendinopathy: a systematic review. Am J Sports Med 2015; 43 (03) 752-761
  • 61 Shakked RJ, Raikin SM. Insertional Tendinopathy of the Achilles: Debridement, Primary Repair, and When to Augment. Foot Ankle Clin 2017; 22 (04) 761-780
  • 62 Traina F, Perna F, Ruffilli A. et al. Surgical treatment of insertional Achilles tendinopathy: a systematic review. J Biol Regul Homeost Agents 2016; 30 (04) (Suppl. 01) 131-138
  • 63 Syed TA, Perera A. A Proposed Staging Classification for Minimally Invasive Management of Haglund's Syndrome with Percutaneous and Endoscopic Surgery. Foot Ankle Clin 2016; 21 (03) 641-664