Can local corticosteroid injection in the retrocalcaneal bursa lead to rupture of the Achilles tendon and the medial head of the gastrocnemius muscle?

Purpose The purpose of the study is to explain the cause–effect relationship in three patients who reported combined ruptures of the Achilles tendon and the gastrosoleus complex 6 months after they had received corticosteroids injections for the management of retrocalcaneal bursitis. Methods Three c...

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Bibliographic Details
Published in:Musculoskeletal surgery 2014-08, Vol.98 (2), p.121-126
Main Authors: Turmo-Garuz, A., Rodas, G., Balius, R., Til, L., Miguel-Perez, M., Pedret, C., Del Buono, A., Maffulli, N.
Format: Article
Language:English
Subjects:
Achilles Tendon - injuries
Adult
Betamethasone - administration & dosage
Bursitis - drug therapy
Cadaver
Calcaneus
Corticosteroids
Glucocorticoids - administration & dosage
Humans
Injections, Intralesional - adverse effects
Male
Medicine
Medicine & Public Health
Muscle, Skeletal - injuries
Original Article
Orthopedics
Rupture
Surgical Orthopedics
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Summary:Purpose The purpose of the study is to explain the cause–effect relationship in three patients who reported combined ruptures of the Achilles tendon and the gastrosoleus complex 6 months after they had received corticosteroids injections for the management of retrocalcaneal bursitis. Methods Three cryopreserved cadavers (three men, three left legs) were examined to assess the anatomic connection between the retrocalcaneal bursa and the Achilles tendon (distal and anterior fibers). Blue triptan medium contrast was injected. Results An unexpected connection between the retrocalcaneal bursa and the anterior fibers of the Achilles tendon was found in all instances. Conclusions Local corticosteroid injection of the retrocalcaneal bursa may help the symptoms of retrocalcanear bursitis, but pose a risk of Achilles tendon rupture. This risk–benefit has to be taken into account when corticosteroid injections are prescribed to professional and high-level athletes.
ISSN:2035-5106
2035-5114
DOI:10.1007/s12306-013-0305-9