Demographic Factors Associated with Insertional and Noninsertional Achilles Tendinopathy

Category: Sports Introduction/Purpose: Achilles tendinopathy is a common clinical entity encountered by orthopaedic surgeons, although the demographics of patients that suffer from this pathology are incompletely understood. It has been suggested that there may be differences in patients that get in...

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Main Authors: Matt Levitsky MD, Justin Greisberg MD, J Turner Vosseller MD, Shirin Dey BA, Briana Hickey BA
Format: Article
Language:English
Published: SAGE Publishing 2019-10-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011419S00275
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author Matt Levitsky MD
Justin Greisberg MD
J Turner Vosseller MD
Shirin Dey BA
Briana Hickey BA
author_facet Matt Levitsky MD
Justin Greisberg MD
J Turner Vosseller MD
Shirin Dey BA
Briana Hickey BA
author_sort Matt Levitsky MD
collection DOAJ
description Category: Sports Introduction/Purpose: Achilles tendinopathy is a common clinical entity encountered by orthopaedic surgeons, although the demographics of patients that suffer from this pathology are incompletely understood. It has been suggested that there may be differences in patients that get insertional (IAT) and noninsertional Achilles tendinopathy (NIAT), and our clinical experience has been that older, less active patients tend to get insertional tendinopathy. The goal of this study is to further investigate the features of patients in a single institution who presented with Achilles tendinopathy. Methods: We used ICD-9 and ICD-10 codes to find patients who presented with Achilles tendinopathy to two foot and ankle surgeons at one academic medical center from 2007-2018. We made note of patient characteristics such as age, gender, BMI, medical comorbidities, and level of activity. Physical examination, including the presence of a gastrocnemius equinus, was noted as well. Characteristics of insertional and non-insertional tendinopathy subgroups were compared using Student’s T-tests and chi- squared tests. Results: The characteristics of 948 consecutive patients were analyzed. The mean age was 55 years and 50.5% of the patients were male. Patients with IAT had significantly higher BMIs than did those with NIAT (30.5 compared to 28.0, p < .05). The mean age was 54.5 years in the IAT group compared to 55.8 years in the NIAT group (p>.05). Patients with NIAT self-identified as active a greater percentage of the time (63% vs 45%, p<0.5). 76% of the IAT group had a gastrocnemius equinus on physical examination, compared to 67% of the non-insertional group. Antecedent fluoroquinolone antibiotic use was only reported in 10% of patients, and all of these patients presented with NIAT. Conclusion: The age at which patients present with insertional and noninsertional Achilles tendinopathy is not significantly different, although patients with NIAT had a lower BMI and self-identified as active a greater percentage of the time. A gastrocnemius equinus was present in a high percentage of patients with both IAT and NIAT. Fluoroquinolone use was not involved in most cases, although, when it was, patients presented with NIAT.
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spelling doaj.art-249b76c31fac4e15831c0fde65193d092022-12-21T20:32:41ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142019-10-01410.1177/2473011419S00275Demographic Factors Associated with Insertional and Noninsertional Achilles TendinopathyMatt Levitsky MDJustin Greisberg MDJ Turner Vosseller MDShirin Dey BABriana Hickey BACategory: Sports Introduction/Purpose: Achilles tendinopathy is a common clinical entity encountered by orthopaedic surgeons, although the demographics of patients that suffer from this pathology are incompletely understood. It has been suggested that there may be differences in patients that get insertional (IAT) and noninsertional Achilles tendinopathy (NIAT), and our clinical experience has been that older, less active patients tend to get insertional tendinopathy. The goal of this study is to further investigate the features of patients in a single institution who presented with Achilles tendinopathy. Methods: We used ICD-9 and ICD-10 codes to find patients who presented with Achilles tendinopathy to two foot and ankle surgeons at one academic medical center from 2007-2018. We made note of patient characteristics such as age, gender, BMI, medical comorbidities, and level of activity. Physical examination, including the presence of a gastrocnemius equinus, was noted as well. Characteristics of insertional and non-insertional tendinopathy subgroups were compared using Student’s T-tests and chi- squared tests. Results: The characteristics of 948 consecutive patients were analyzed. The mean age was 55 years and 50.5% of the patients were male. Patients with IAT had significantly higher BMIs than did those with NIAT (30.5 compared to 28.0, p < .05). The mean age was 54.5 years in the IAT group compared to 55.8 years in the NIAT group (p>.05). Patients with NIAT self-identified as active a greater percentage of the time (63% vs 45%, p<0.5). 76% of the IAT group had a gastrocnemius equinus on physical examination, compared to 67% of the non-insertional group. Antecedent fluoroquinolone antibiotic use was only reported in 10% of patients, and all of these patients presented with NIAT. Conclusion: The age at which patients present with insertional and noninsertional Achilles tendinopathy is not significantly different, although patients with NIAT had a lower BMI and self-identified as active a greater percentage of the time. A gastrocnemius equinus was present in a high percentage of patients with both IAT and NIAT. Fluoroquinolone use was not involved in most cases, although, when it was, patients presented with NIAT.https://doi.org/10.1177/2473011419S00275
spellingShingle Matt Levitsky MD
Justin Greisberg MD
J Turner Vosseller MD
Shirin Dey BA
Briana Hickey BA
Demographic Factors Associated with Insertional and Noninsertional Achilles Tendinopathy
Foot & Ankle Orthopaedics
title Demographic Factors Associated with Insertional and Noninsertional Achilles Tendinopathy
title_full Demographic Factors Associated with Insertional and Noninsertional Achilles Tendinopathy
title_fullStr Demographic Factors Associated with Insertional and Noninsertional Achilles Tendinopathy
title_full_unstemmed Demographic Factors Associated with Insertional and Noninsertional Achilles Tendinopathy
title_short Demographic Factors Associated with Insertional and Noninsertional Achilles Tendinopathy
title_sort demographic factors associated with insertional and noninsertional achilles tendinopathy
url https://doi.org/10.1177/2473011419S00275
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