Evidenzbasierte Therapie der Achillessehnen-Tendinopathie und -Ruptur

SummaryAchilles tendon (AT) tendinopathies and ruptures are the most common diagnoses in AT disorders.Eccentric training is an established gold standard in the treatment of Achilles tendinopathies (LoE 1). Equally effective are doppler-ultrasound guided operations and sclerosing therapies as well as insoles in combination with physiotherapy (LoE 1). Currently not advisable are orthoses, low-lever laser, night splint therapies or nitroglycerin patches (LoE 1-2).The current trend goes towards non-operative treatment of AT ruptures in the sedentary population and recreational athletes (LoE 1). In elite athletes, an operation with the associated lower rerupture rate is advised (LoE1). No operation technique (open vs. percutaneous) can be advised as the single best. Functional bracing is clearly advantageous over cast immobilization (LoE 1).Platelet-rich plasma (PRP) can at the current point (not yet) be advised, neither for Achilles tendinopathies (LoE 1) nor AT ruptures (LoE 1), even though a positive effect has been shown in animal models.