To evaluate the clinical efficacy and safety of arthroscopic treatment for refractory insertional Achilles tendinopathy.

A retrospective study of 36 patients with refractory insertional Achilles tendinopathy admitted to Shenzhen Pingle Orthopaedic Hospital (Shenzhen Pingshan District Hospital of Traditional Chinese Medicine) between January 2021 and January 2024. All the patients underwent arthroscopic osteophyte debridement and Achilles tendon release. Surgical duration, intraoperative blood loss, postoperative weight-bearing time, and complications were recorded. Clinical outcomes were assessed using the visual analog scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Measurement data were described as mean±standard deviation. The paired-samples ttest was used for within-group comparison between preoperative and postoperative data. Categorical data were presented as cases. The difference was considered statistically significant when P<0.05.

All 36 patients were followed up with an average follow-up time of (6.7±2.0) months. No complications such as infection or Achilles tendon rupture were observed. After operation, VAS score was 2.3±1.1 which was lower than the score 6.3±1.4 before operation; the AOFAS score was 76.2±5.8 which was higher than 92.1±5.9 before operation; the differences were statistically significant (t=15.683, 36.796, both P<0.05).

Arthroscopic treatment for refractory insertional Achilles tendinopathy exhibits positive effects and excellent recovery rate, good postoperative outcomes and minor adverse events, which is certainly worthy of clinical recommendation.