One fifth of patients with Achilles tendinopathy have symptoms after 10 years: A prospective cohort study

Lagas, I. F. et al. J Sport Sci 1–9 (2023)


Patients with midportion Achilles tendinopathy (AT) are thought to experience a gradual symptomatic improvement over time. The aim of this study was to prospectively investigate if patients with midportion AT have symptoms at 10-year follow-up. Patients with midportion AT were invited to complete an online questionnaire 10 years after inclusion in an intervention trial. The primary outcome was the presence of AT symptoms. Secondary outcomes were: the Victorian Institute of Sports Assessment-Achilles tendinopathy (VISA-A, 0–100) score and sports activity level. Of the 54 patients included, 43 (80%) completed the questionnaire at an average follow-up of 10.4 years. Persisting symptoms were reported by 19%. The mean (standard deviation-SD) VISA-A score improved from 52 (17) at baseline to 79 (21) at 10-years follow-up with a mean change of 27 points (95% confidence interval: 21; 35, p < 0.001). Of the 38 active patients, 16 (42%) returned to their pre-injury level sports, of whom 14 (37%) performed them pain free. One-fifth of patients with conservatively treated midportion AT still have symptoms after 10years. One- third of patients were able to perform sports pain-free at pre-injury level. Patients should be adequately counselled to give realistic expectations.