Efficacy of dexamethasone iontophoresis as treatment for insertional Achilles tendonitis.

Background: Dexamethasone iontophoresis has been used to treat insertional Achilles tendonitis with varying effects.

Purpose: This retrospective study evaluated the effectiveness of dexamethasone iontophoresis (DI) in patients with insertional Achilles tendinopathy (IAT) or retrocalcaneal bursitis.

Study design and method: We analyzed 159 patients, of which 87 received three or more DI treatments. We compared first and last-visit pain scores, range of motion (ROM), and posterior heel spur size radiographic measurements.

Results: No significant differences between treatment groups were observed in pain or ROM (p-values >0.3). However, a substantial difference in posterior heel spur size was found, with more prominent spurs associated with more than three treatments (p-value = 0.019). Although not statistically significant, it was noted that increased spur size and Haglund bump height were linked to a higher likelihood of surgical intervention.

Conclusion: This study suggests DI may provide short-term relief in IAT but does not significantly improve long-term functional outcomes. Radiographic analysis can guide treatment, particularly in more prominent posterior heel spurs. Further prospective research is needed to explore the long-term efficacy of DI in managing IAT.