BACKGROUND & OBJECTIVE
There are many studies examining risk factors for Achilles tendinopathy. Of all the published studies there are many employed methodologies. Some methods allow for accurate conclusions to be made relative to a risk factor and tendinopathy, whilst others do not. At present there are no published systematic reviews on the subject – hence the reason for this paper. Understanding clinical risk factors may inform prevention and treatment strategies. As such, this study was well justified.
A robust systematic review methodology was employed to ensure all appropriate articles were included and reviewed using a high level of methodological robustness. The review was registered prospectively on PROSPERO. The Inclusion criteria was: cohort studies (either prospective or retrospective) published in English. Exclusion criteria included imaging studies as the authors stated that this is not normally clinically available in a consultation. In addition, the authors were willing to examine novel risk factors using cross-sectional studies, essentially broadening the net. The authors rightly identified this type of study design as weaker when it comes to examining the relationship between a risk factor and tendinopathy development.
10 cohort studies were identified and considered to be at high risk of bias. This comprised of 8 prospective and 2 retrospective studies. The authors reported limited evidence for 9 factors: “1) prior lower limb tendinopathy or fracture, (2) use