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EXTRACORPOREAL SHOCKWAVE THERAPY FOR THE TREATMENT OF CHRONIC ACHILLES TENDONITIS.

University Hospital of Wales, Dept of Trauma & Orthopaedics, Heath Park, Cardiff CF14 4XW

In a prospective study to evaluate the benefits of radial extracorporeal shockwave therapy (ESWT) in patients with longstanding chronic Achilles tendonitis. 34 cases of non-insertional Achilles tendonitis were treated in 32 patients, using radial shockwave treatment. Symptoms had been present for at least ten months and were resistant to conservative treatments. Patients received three shockwave sessions at weekly intervals. Evaluation was performed prior to treatment, at six weeks and three months after the final session. Patients completed a visual analogue score (VAS) for maximal pain (0–100), the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot Scale and the Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A).

At short-term review all patients reported an improvement in symptoms. The VAS fell from a pre-treatment value of 74 (+/–15) to 22 (+/–17). An improvement in the AOFAS from of 64 (+/–10) to a post-treatment value of 90(+/–7) was seen, and an average from 30 to 70 in the VISA-A score. No complications from the treatment were reported. Four patients previously listed for surgery have improved sufficiently to be removed from the waiting list.

Conclusion: Short-term results using ESWT for the treatment of longstanding non-insertional Achilles tendonitis are encouraging. Longer-term follow-up subsequent to this prospective pilot study is underway to assess if results are reproducible over a greater time period.

The abstracts were prepared by Mr Tim Briggs. (Editoral Secretary 2003/4) Correspondence should be addressed to him at Lane Farm, Chapel Lane, Totternhoe, Dunstable, Bedfordshire LU6 2BZ, United Kingdom