Does Functional Rehabilitation Improve Outcomes After Double-row Suture Anchor Repair For Insertional Achilles Tendinopathy?

PURPOSE: Insertional Achilles tendinosis (IAT) is commonly seen in running athletes, but can affect patients of all ages. When conservative treatment fails, surgical treatment is usually performed after months of unsuccessful attempts to control symptoms. In addition to surgical treatment, rehabilitation plays an important role in the treatment process. Traditional immobilization with casting and novel functional rehabilitation with early weightbearing in a walking boot has been reported in the literature. This retrospective study of patients who completed a double-row surgical technique for the treatment of IAT sought out to compare two methods of rehabilitation: Group 1 (G1) were submitted to non-functional (traditional) rehabilitation program and Group 2 (G2) were submitted to an early and functional postoperative rehabilitation program. METHODS: METHODS: We retrospectively reviewed the charts of patients with IAT who underwent surgical correction of Achilles tendinosis with complete detachment of the Achilles tendon and subsequent reattachment with double role suture (SpeedBridge System - Arthrex, Naples, FL) from August 2010 and 2020. G1 had 48 patients (51 feet) and G2 had 17 patients(17 feet). Following a minimum 2-year follow-up (range:2-9 years; mean 32 months) pre and post-op information from all patients in both groups were compared. This study received approval from the Ethics Committee of Felício Rocho Hospital. RESULTS: Visual Analogic Pain Scale (VAS) pre/post G1 (7.49/1.39), G2 (7.8/2.2) had similar change before and after intervention within groups. FAAM-ADL was assessed only in the post-operative period and was statistically significantly higher in the G1 group(83.9 ± 16.3 vs.74.4 ± 11.33; P < 0.01) with delta reaching MCID. However, the sample size for G2 is small in comparison to G1. CONCLUSIONS: Functional rehabilitation and standard rehabilitation led to similar decrease in pain at a 2 year follow-up. Functional scores were higher in the standard rehabilitation. However, sample size of functional rehabilitation was small requiring more studies further analyses.