Clinical Outcomes of Proximal Medial Gastrocnemius Recession in the Treatment of Non-Insertional Achilles Tendinopathy

Research Type: Level 4 – Case series Introduction/Purpose: Non-insertional Achilles tendinopathy is a common and disabling condition, particularly among athletes. Current interventional treatments include medication or orthobiologic infiltration and surgical procedures such as tendon transfers. This study aimed to evaluate the outcomes of proximal medial gastrocnemius recession (PMGR), a procedure with relatively low morbidity, in the treatment of non-insertional Achilles tendinopathy. Methods: Twelve patients with a diagnosis of non-insertional Achilles tendinopathy, made by clinical examination and confirmed by nuclear magnetic resonance imaging, refractory to conservative treatment underwent PMGR. Five patients had bilateral involvement, resulting in 17 tendons treated. Results: After a mean follow-up of 32 months, the mean AOFAS score increased from 62.0 preoperatively to 90.2 at last follow-up. The mean pain score on an analog scale decreased from 6.7 preoperatively to 1.9 at last follow-up. While some patients experienced residual pain, it was milder than preoperative pain in all cases, and all participants reported satisfaction with the treatment. Conclusion: Despite the small sample size and short follow-up period, the results were promising. As PMGR is a relatively simple procedure with accelerated rehabilitation compared to tendon reconstruction techniques, it may be an attractive alternative treatment for this common and disabling disorder. Figure 2 Proximal medial gastrocnemius exposed.