Tendón de Aquiles anatomía e insuficiencia

Introduction: the main aspects of Achilles tendon (AT) insufficiency were determined through the review of classic texts and current literature on the topic, to acquire the various conceptual and therapeutic tools in clinical practice. Methodology: we used the PubMed, Clinical Key, Embase, Cochrane and Lilacs search engines, including references in Spanish and English published between 1980 and 2020. Articles were reviewed using the CONSORT, STROBE or PRISMA guidelines, as appropriate. Results: 30 articles directly related to the topic were selected. Meta-analyses, systematic reviews, prospective and observational studies, and narrative reviews were included. Discussion: there is a wide spectrum of intrinsic and extrinsic predisposing risk factors for the development of AT insufficiency, but its etiology remains unclear. The mainstay treatment for tendinopathies in general, is rehabilitation provided by trained personnel. The surgical approach, by percutaneous or open surgical release techniques, is reserved for cases in which conservative approaches fail. Nonsurgical treatment for ruptured AT has shown excellent outcomes if patients undergo a strict rehabilitation process following diagnosis, however, in our socioeconomic context, tendon repair surgery continues to be a first-line therapeutic pillar. Conclusion: this review provides basic concepts and their correlation with biomechanics, indispensable for an early diagnosis and successful treatment. Introducción: mediante la revisión del tema apoyada en los textos clásicos y la literatura actual, se formulan los principales aspectos de la insuficiencia del tendón de Aquiles para adquirir diferentes herramientas conceptuales y terapéuticas en la práctica clínica. Metodología: los motores de búsqueda utilizados fueron PubMed, Clinical Key, Embase, Cochrane y Lilacs, se incluyeron referencias en español e inglés, publicadas entre 1980 y 2020. Los artículos se revisaron utilizando CONSORT, STROBE o PRISMA, según el caso. Resultados: fueron seleccionados 30 artículos, entre ellos metanálisis, revisiones sistemáticas, estudios prospectivos, observacionales y revisiones narrativas. Discusión: existe un amplio espectro de factores de riesgo para la insuficiencia, intrínsecos y extrínsecos, que la predisponen, aunque la etiología sigue siendo incierta. Para las tendinopatías en general el tratamiento de elección es la rehabilitación realizada por personal capacitado, reservando el abordaje quirúrgico para los cas