RESEARCH Open Access Insertional Achilles

tendinopathy is associated with arthritic changes of the posterior calcaneal cartilage: a retrospective study Ezequiel Palmanovich1,2*, Yael Oshri3, Yaron S. Brin1,2, Evgeny Edelshtein1, Meir Nyska1,2 and Iftach Hetsroni1,2 Background: To characterize the histological changes within the posterior calcaneal cartilage in patients with insertional Achilles tendinopathy (IAT) and test the relationships between severity of the histological changes and level of functional impairment. Methods: Sixteen posterior calcaneal wall specimens of patients with IAT who had posterior calcaneal ostectomy were investigated. Hematoxylin-eosin stain, Toluidine-blue stain, Polarized light microscopy, and Masson Trichrome stain were used to characterize histological changes. Changes within the posterior calcaneal wall cartilage were graded according to Osteoarthritis Research Society International (OARSI) criteria. Functional scores were completed at the time of surgery according to the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score. Results: Mean age of patients was 48.9 years. Histological findings within the posterior calcaneal wall cartilage specimens were consistent with arthritic changes. OARSI grading indicated Grade 2 changes in one specimen