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Clin Sports Med. 2015 Oct;34(4):607-24. doi: 10.1016/j.csm.2015.06.010. Epub 2015 Jul 31.

Chronic Achilles Tendon Disorders: Tendinopathy and Chronic Rupture.

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Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Via Allende, Baronissi, Salerno 84081, Italy; Department of Musculoskeletal Disorders, Centre for Sports and Exercise Medicine, Mile End Hospital, Barts and the London School of Medicine and Dentistry, Mary University of London, 275 Bancroft Road, London E1 4DG, UK. Electronic address:
Department of Orthopaedic and Traumatology, School of Medicine, University of Rome ''Tor Vergata", Viale Oxford 81, Rome 00133, Italy.


Tendinopathy of the Achilles tendon involves clinical conditions in and around the tendon and it is the result of a failure of a chronic healing response. Although several conservative therapeutic options have been proposed, few of them are supported by randomized controlled trials. The management is primarily conservative and many patients respond well to conservative measures. If clinical conditions do not improve after 6 months of conservative management, surgery is recommended. The management of chronic ruptures is different from that of acute ruptures. The optimal surgical procedure is still debated. In this article chronic Achilles tendon disorders are debated and evidence-based medicine treatment strategies are discussed.


Achilles tendinopathy; Chronic Achilles tendon rupture; Mini-invasive surgery; Neglected ruptures

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