The long-term outcome of tendon lengthening for chronic Achilles tendon pain

Background: The purpose of this study was to assess the longterm results of tendon lengthening surgery for the treatment of chronic Achilles tendon pain. Methods: The results of 21 procedures in 18 patients were assessed. Each patient had an open Z-plasty to lengthen the Achilles tendon by I cm. Results: Results showed a long-term (7.5 years) reduction in visual analogue pain scores for sporting activity in 20 of 21 procedures (median 50 point reduction,p < 0.0005). The tendon lengthening was apparent in a mean increase in dorsiflexion of 5 degrees. Two patients had minor gait abnormalities postoperatively. One patient had a reduction in plantarilexion power on the operated side, but five patients had improved power compared to the nonoperated limb. One major and five minor surgical complications were noted. Conclusions: The retrospective nature of this study must be noted in drawing conclusions. However, the results suggest excellent long-term reduction of Achilles pain after tendon lengthening. This must be weighed against a relatively high complication rate for any procedure in this region. This treatment does not appear to cause long-term deficits in plantarflexion power or gait.