Clinical results of proximal release of the medial gastrocnemius in the treatment of non-insertional Achilles tendon tendinopathy

Abstract

Introduction: Noninsertional tendinopathy of the Achilles tendon is a common and disabling condition, particularly in athletes. Current interventional treatments include medications, infiltrations, and surgical procedures such as tendon transfers. This study aimed to evaluate the results of proximal release of the medial gastrocnemius (PMGR), a relatively low-morbidity procedure, in the treatment of noninsertional Achilles tendon tendinopathy. Methods: Twelve patients diagnosed with non-insertional Achilles tendon tendinopathy, as determined by clinical examination and confirmed by nuclear magnetic resonance, who were refractory to conservative treatment underwent PMGR. Five patients had bilateral involvement, resulting in 17 treated tendons. Results: After a mean follow-up of 32 months, the mean AOFAS score increased from 62.0 preoperatively to 90.2 at the last follow-up. The mean pain score on an analog scale decreased from 6.7 preoperatively to 1.9 at the last follow-up. Although some patients had residual pain, in all cases it was milder than preoperative pain, and all participants reported satisfaction with the treatment performed. Conclusion: Despite the small sample size and short follow-up period, the results indicate that PMGR is a less invasive alternative for treating noninsertional Achilles tendinopathy.