# Effects of Ultrasound‐Guided Tenotomy and Debridement on Pain, Function, and Psychological Factors for Achilles Tendinopathy: A Prospective Cohort Study

## TL;DR

A minimally invasive ultrasound-guided procedure for chronic Achilles tendon pain reduces pain and improves function and psychological factors over time.

## Contribution

This study evaluates the long-term effects of ultrasound-guided tenotomy and debridement on pain, function, and psychological outcomes in chronic Achilles tendinopathy patients.

## Key findings

- Significant improvements in pain, function, kinesiophobia, and pain catastrophizing were observed at 6 weeks and maintained at 1 year.
- Haglund deformity and intratendinous calcifications were linked to smaller functional improvements.
- No procedure-related complications were reported over the 1-year follow-up.

## Abstract

Ultrasound‐guided tenotomy and debridement is a minimally invasive treatment with a low risk of complications for individuals with chronic Achilles tendinopathy. Yet the benefits of this procedure on pain, function, and pain‐related psychological factors, as well as predictors of treatment success, remain understudied. A total of 56 individuals with chronic Achilles tendinopathy (mean (SD): age = 55.9 (11) years, BMI = 34.8 (8.2) kg/m2, women = 68%) underwent baseline ultrasonography, followed by ultrasound‐guided tenotomy and debridement, and rehabilitation. Participants reported pain (0–10), function (Foot and Ankle Ability Measure—ADL), kinesiophobia (Tampa Scale of Kinesiophobia‐17), and pain catastrophizing (Pain Catastrophizing Scale) at baseline and for a year following the procedure. Baseline pain was 6.1 (2.2), kinesiophobia was 40.8 (7.1), pain catastrophizing was 13.7 (10.2), and function was 55.9 (17.3). By 6 weeks, there were decreases in pain (mean change (95% CI): −1.9 (−1.1 to −2.6), function: 14.4 (9.3–19.5), kinesiophobia: −5 (−3.2 to −6.9), and pain catastrophizing: −7 (−4.9 to −9.1)). Patient‐reported outcomes were similar at 52 weeks (pain: −2.99 (−2.2 to −3.8), function: 25.1 (19.6–30.7), kinesiophobia: −7.5 (−6.1 to −11.4), catastrophizing: −8.5 (−6.1 to −10.8)) following the procedure. Haglund deformity (β: −13.1 (−0.6 to −25.5)) and intratendinous calcifications (β: −14.7 (−1.4 to −28.1)) were associated with smaller improvements in function. No procedure‐related complications were reported. Clinical significance: Ultrasound‐guided tenotomy and debridement for chronic Achilles tendinopathy may provide positive outcomes for pain, function, and pain‐related psychological factors at 6‐week and 1‐year follow‐up. Haglund deformity and tendon calcifications were associated with smaller improvements in function.