Excellent Clinical Outcomes and Rapid Return to Activity Following In-Office Needle Tendoscopy for Chronic Achilles Tendinopathy

PurposeThe purpose of this retrospective study was to assess outcomes following Achilles in-office needle tendoscopy (IONT) for the treatment of chronic Achilles tendinopathy (cAT) at a minimum of 12-month follow-up.MethodsA retrospective case series was conducted to evaluate patients who underwent Achilles IONT for cAT between January 2019 and December 2022. Inclusion criteria were patients ≥18 years of age and clinical history, physical history, and MRI findings consistent with cAT who failed a minimum of 3-months of conservative management for which each patient underwent Achilles IONT and had a minimum of 12-month follow-up. Clinical outcomes were evaluated using the Victorian Institute of Sport Assessment-Achilles (VISA-A) and visual analog scale (VAS) scores. Patient satisfaction was measured at the final follow-up visit with a 5-point Likert scale.ResultsTwelve patients (13 Achilles) with a mean age of 50.9 ± 14.6 years were included in the study. The mean follow-up time was 26.3 ± 6.3 months. The mean VISA-A scores improved from a pre-operative score of 35.6 ± 5.9 to a postoperative score of 83.6 ± 14.1 (p < 0.001). The mean VAS improved from a preoperative score of 6.6 ± 1.0 to a postoperative score of 1.3 ± 1.7 (p < 0.001). There were 10 patients (83.3%) who participated in sports activities before the IONT procedure. Within this group, 9 patients (90.0%) returned to play at a mean time of was 5.9 ± 2.6 weeks. The mean time to return to work was 4.2 ± 1.2 days. Patients reported an overall positive IONA experience with a mean rating scale of 4.5 ± 0.9.ConclusionsThis retrospective review demonstrated that Achilles IONT for the treatment of cAT results in significant improvements in subjective clinical outcomes and a low complication rate together with high patient satisfaction scores at short-term follow-up.