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It is possible to release the plantaris tendon under ultrasound guidance: a technical description of ultrasound guided plantaris tendon release (UPTR) in the treatment of non-insertional Achilles tendinopathy

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Open plantaris tendon excision and ventral paratendinous stripping is a recognised treatment option in selected patients with non-insertional Achilles tendinopathy. The aim of this study was to develop a minimally invasive outpatient technique of ultrasound guided plantaris tendon release (UPTR).

Methods

A 19 gauge needle, 15 gauge scalpel blade, hook knife (Smith and Nephew, Boston, MA, USA) and a beaver blade (Arthrex, Naples, FL, USA), were used under ultrasound guidance to identify and divide the plantaris tendon in 12 cadaveric legs. Specimens were dissected to identify whether division of the plantaris tendon had been successful. UPTR was subsequently performed on patients.

Results

The 15 gauge scalpel blade, hook knife (Smith and Nephew, Boston, MA, USA) and beaver blade (Arthrex, Naples, FL, USA) were all able to cut the plantaris tendon. However, on dissection the hook knife (Smith and Nephew, Boston MA) caused less damage to surrounding structures. Subsequently, the plantaris tendon was successfully divided in three patients using UPTR technique without complication.

Conclusion

UPTR is a viable technique for treating plantaris related non-insertional Achilles tendinopathy.

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Funding

No funding was required for this study.

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Authors and Affiliations

  1. Fortius Clinic, London, England, UK

    Ben Hickey, Justin Lee, Jo Stephen, Jarrod Antflick & James Calder

  2. The Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, UK

    Jo Stephen & James Calder

  3. Wrexham Maelor Hospital, Wrexham, Wales

    Ben Hickey

Authors
  1. Ben Hickey
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  2. Justin Lee
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  3. Jo Stephen
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  4. Jarrod Antflick
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  5. James Calder
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Conflict of interest

The authors have declared no conflicts of interest.

Ethical approval

Institutional review board approval was granted by Imperial college healthcare tissue bank (ID R16027-1A) and Hampstead research ethics committee (ID 16/LO/0188).

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Hickey, B., Lee, J., Stephen, J. et al. It is possible to release the plantaris tendon under ultrasound guidance: a technical description of ultrasound guided plantaris tendon release (UPTR) in the treatment of non-insertional Achilles tendinopathy. Knee Surg Sports Traumatol Arthrosc 27, 2858–2862 (2019). https://doi.org/10.1007/s00167-019-05451-0

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  • DOI: https://doi.org/10.1007/s00167-019-05451-0

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