130例跟腱止点腱病流行病学特点分析

Epidemiological analysis of 130 cases of insertional Achilles tendinopathy

目的跟腱止点腱病是常见的足踝部慢性运动损伤之一,本研究旨在分析跟腱止点腱病的临床特点和流行病学情况。方法回顾性分析2010年1月—2022年10月陆军军医大学第一附属医院运动医学中心手术治疗的130例跟腱止点腱病患者临床资料,其中男性99例,女性31例;年龄11~70岁,平均42.2岁。按照年龄分为中青年组(<40岁)和中老年组(≥40岁),比较两组患者性别、受伤侧别、病程、体质量指数(body mass index,BMI),合并跟骨Haglund畸形、跟腱止点异位骨化和跖腱膜止点骨刺等情况。通过足侧位X线片检查将患者按照是否出现跟腱止点异位骨化分为异位骨化组和无异位骨化组,比较两组患者的性别、侧别、年龄、病程、BMI,合并跟骨Haglund畸形和跖腱膜止点骨刺等情况。结果按年龄分组,女性患者在中老年组中占比较高(77.4%,χ2=7.477,P=0.006);合并跖腱膜止点骨刺的患者在中老年组占比较高(73.1%,χ2=10.081,P=0.001)。按是否出现异位骨化分组,发现跟腱止点异位骨化与年龄相关,异位骨化组患者占比随年龄增加逐渐增加(χ^(2)=14.733,P=0.012)。跟腱止点异位骨化患者占比随BMI增加逐渐增加(χ^(2)=8.107,P=0.017)。跟腱止点异位骨化与跖腱膜止点骨刺二者具有相关性(χ^(2)=12.821,P<0.001)。结论跟腱止点腱病患者中,中老年患者常合并出现跖腱膜止点骨刺,跟腱止点异位骨化与患者年龄、BMI及跖腱膜止点骨刺相关。

Objective To analyze the clinical and epidemiological characteristics of insertional Achilles tendinopathy.Methods General data of 130 patients with insertional Achilles tendinopathy were retrospectively analyzed from Jan.2010 to Oct.2022 in the Sports Medicine Center of the First Affiliated Hospital of Army Medical University.There were 99 male and 31 female,aged 11-70 years,mean 42.2 years.Patients were divided into young and middle-aged(<40 years)and elderly group(≥40 years).Gender,injury side,injury course,body mass index(BMI),combination of calcaneal Haglund deformity,heterotopic ossification of Achilles tendon and bone spur of the metatarsal aponeurosis were compared between two age groups.Then patients were further divided into heterotopic ossification group and non-heterotopic ossification group,to investigate the parameters of gender,injury side,age,injury course,BMI,combination of calcaneal Haglund deformity and metatarsal aponeurosis spurs.Results Among the 130 patients with insertional Achilles tendinopathy,based on age grouping,female patients(77.4%,χ^(2)=7.477,P=0.006)and patients with metatarsal aponeurosis interstitial spur(73.1%,χ^(2)=10.081,P=0.001)accounted for a significantly higher proportion in the elderly group.Based on heterotopic ossification grouping,it was found that heterotopic ossification of Achilles tendon was related to age and BMI,whose proportion gradually increased with the increase of age(χ^(2)=14.733,P=0.012)and BMI(χ^(2)=8.107,P=0.017).It was also related with the combination of metatarsal aponeurosis insertion spur(χ^(2)=12.821,P<0.001).Conclusion In patients with insertional Achilles tendinopathy,those of≥40 years old often combine with metatarsal aponeurosis spurs.Heterotopic ossification of Achilles tendon insertion is related with increased age and BMI,and combination of metatarsal aponeurosis spurs.