@article{AlfredsonWaldenRobertsetal.2023,
  author    = {Alfredson, H{\aa}kan and Wald{\´e}n, Markus and Roberts, David and Spang, Christoph},
  title     = {Combined midportion Achilles and plantaris tendinopathy: a 1-year follow-up study after ultrasound and color-Doppler-guided WALANT surgery in a private setting in southern Sweden},
  series = {Medicina},
  volume    = {59},
  journal   = {Medicina},
  number    = {3},
  issn      = {1648-9144},
  doi       = {10.3390/medicina59030438},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-303966},
  year      = {2023},
  abstract  = {Background and Objectives: Chronic painful midportion Achilles combined with plantaris tendinopathy can be a troublesome condition to treat. The objective was to prospectively follow patients subjected to ultrasound (US)- and color doppler (CD)-guided wide awake, local anesthetic, no-tourniquet (WALANT) surgery in a private setting. Material and Methods: Twenty-six Swedish patients (17 men and 9 women, mean age 50 years (range 29-62)) and eight international male patients (mean age of 38 years (range 25-71)) with combined midportion Achilles and plantaris tendinopathy in 45 tendons altogether were included. All patients had had >6 months of pain and had tried non-surgical treatment with eccentric training, without effect. US + CD-guided surgical scraping of the ventral Achilles tendon and plantaris removal under local anesthesia was performed on all patients. A 4-6-week rehabilitation protocol with an immediate full-weight-bearing tendon loading regime was used. The VISA-A score and a study-specific questionnaire evaluating physical activity level and subjective satisfaction with the treatment were used for evaluation. Results: At the 1-year follow-up, 32/34 patients (43 tendons) were satisfied with the treatment result and had returned to their pre-injury Achilles tendon loading activity. There were two dropouts (two tendons). For the Swedish patients, the mean VISA-A score increased from 34 (0-64) before surgery to 93 (61-100) after surgery (p < 0.001). There were two complications, one wound rupture and one superficial skin infection. Conclusions: For patients suffering from painful midportion Achilles tendinopathy and plantaris tendinopathy, US + CD-guided surgical Achilles tendon scraping and plantaris tendon removal showed a high satisfaction rate and good functional results 1 year after surgery.},
  language  = {en}
}