Hello, I will be discussing our paper Clinical Outcomes of Extracorporeal Shockwave Therapy for Achilles Tendinopathy, an Analysis of Injury Location, Age, and Body Mass Index. These are the relevant disclosures. Extracorporeal shockwave therapy or shockwave therapy is one of the major advances in orthopedic surgery over the last 20 years as a method for orthopedic surgeons to conservatively treat tendon pathologies such as Achilles tendinopathy. Unfortunately, previous studies involve only a small number of cases, relatively short duration of symptoms, and simple measures of pain. The purpose of this study is to evaluate the impact of age, body mass index or BMI, and location of Achilles tendinopathy insertional or non-insertional on clinical outcomes and return to sport time after shockwave therapy. This is a retrospective cohort study that included existing clinical data from 40 patients from a single academic institution. Patients greater than 18 years of age who underwent shockwave therapy for Achilles tendinopathy in the office setting between August 1st, 2019 to August 30th, 2021 were included. Clinical outcomes of patients were assessed through self-reported visual analog scale VAS and Victorian Institute of Sports Assessment Achilles visa scores for assessing pain and functional outcomes of Achilles tendinopathy. Descriptive statistics were used to provide an overview of the patient characteristics including sex, age, laterality of injury, BMI, duration of symptoms, return to sport time, and follow-up. For these data, mean and standard deviation were calculated and paired samples t-tests and Welch's t-tests were performed on clinical outcome scores. This study included 48 patients, 62 heels, with an average age of 50.8 plus or minus 14.2 years, BMI of 27.3 plus or minus 5.3, follow-up of 6.41 plus or minus 6.9 months, and return to sport time or return to play time of 5.39 plus or minus 5.3 weeks. Patients with a BMI less than 25 had significantly higher post-operative visa scores compared to those with a BMI greater than 25 and post-operative VAS scores displayed this trend without significance. Patients less than or equal to 50 years old had significantly higher post-operative visa scores compared to those greater than 50 years old and post-operative VAS scores displayed this trend without significance as well. Pre- and post-operative visa A scores and post-operative VAS scores were not significantly different between insertional and non-insertional cohorts except for pre-operative VAS scores where the non-insertional cohort was higher. Additionally, we found significant improvements in pre-operative to post-operative scores for VAS scores for both the insertional and non-insertional cohorts as well for the visa A for the insertional cohort, but no significant improvement in visa A for the non-insertional cohort. In conclusion, increased BMI and age are determined factors that significantly adversely affect functional scores, visa A, in patients with Achilles tendinopathy treated with shockwave therapy, but no significant differences were found for these risk factors in terms of pain improvement VAS. Additionally, we found that the non-insertional cohort had significantly higher pre-operative pain than IAT and no significant improvement in visa scores, though there was a trend of functional improvement. This aligns with the fact that the mid-substance of the Achilles tendin is a watershed area with relatively low vascularity compared to the insertional portion where lower perfusion weakens the healing benefits of shockwave therapy. Thank you.

clinical outcomes

shockwave therapy

Achilles tendinopathy

age

BMI