Disclosures: Kayle E. Noble-Taylor, DO: No financial relationships or conflicts of interest

Background and/or Objectives: To describe the outcomes of ultrasound-guided (USG) tendon scraping (TS) for mid-portion and insertional Achilles tendinopathy.

Design: Retrospective case series.

Setting: Outpatient sports medicine clinic at an academic institution.

Participants: Patients who underwent USG TS for mid-portion and insertional tendinopathy.

Interventions: TS is a procedure performed under USG using a meniscotome and/or needle with injection of normal saline to separate the deep surface of the Achilles tendon from underlying structures, and thereby, mechanically ablate neovessels (and accompanying neonerves) that are purported to cause pain in Achilles tendinopathy. Two reviewers independently performed a retrospective chart review of patients that underwent USG TS for mid-portion and insertional Achilles tendinopathy between July 2013 and October 2020. Procedural follow-up documentation was examined for outcome measures. If there was no documented follow up, patients were contacted via telephone.

Main Outcome Measures: Complications, peak self-reported pain relief, return to goal activity, progression to secondary interventions, time to secondary intervention, and improvement with secondary intervention were recorded.

Results: USG TS was performed on 24 tendons (15 mid-portion and 9 insertional) diagnosed with Achilles tendinopathy by the senior author (JS). Patient age ranged from 35-69 years (mean 53.9 mid-portion, 53 insertional). “Excellent” pain relief was reported for 60% and 56% of patients for mid-portion and insertional pathology respectively. 67% with mid-portion and 89% with insertional pathology returned to their goal activity initially after the procedure. 53% with mid-portion and 57% with insertional pathology went on to have a secondary intervention. Of those who underwent a secondary intervention, 88% with mid-portion and 80% with insertional pathology improved with the secondary intervention. No complications were observed.

Conclusions: These findings suggest USG TS is a safe procedure and may be a reasonable treatment option to consider for both mid-portion and insertional Achilles tendinopathy, especially for in-season athletes given the limited recovery time required and potential for rapid return to activity.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/ultrasound-guided-tendon-scraping-outcomes-for-mid-portion-and-insertional-achilles-tendinopathy-a-retrospective-case-series/