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Achilles Tendinosis Surgery

 

Written by Dr Mike Smith

If you have chronic pain over your achilles tendon then you may have ‘Achilles Tendinosis’

Lets take a look at what this means

In contrast to achilles tendinitis, the term achilles tendinosis refers to the achilles tendon undergoing degeneration over time, leading to this chronic condition. Achilles tendinosis can classically occur in two distinct areas of the achilles tendon

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Achilles Tendinosis Surgery

Surgical management of achilles tendinosis / tendinitis is most frequently performed for patients suffering from insertional achilles tendinosis. There are multiple causes of ‘achilles pain’ experienced in this condition, and all of these aspects are addressed at the time of the procedure, through the same incision.

 

Achilles Tendinosis 

With time, the lower end of the achilles tendon undergoes degeneration. At the time of the procedure, any degenerative tissue is removed, to alleviate this pain generator.

Haglund Deformity 

A ‘Haglund deformity’ relates to excessive bone formation at the back of the calcaneus (heel bone). This can result in irritation of the achilles tendon itself, as well as the adjacent bursa (Retrocalcaneal Bursa). This can be particularly painful when rubbing on the back of shoes. This excessive bone lump is removed at the time of surgery.

Retrocalcaneal Bursitis 

The retrocalcaneal bursa sits behind the heel bone (calcaneus) and infront of the achilles tendon. Irritation of this ‘bursa’ results in pain at the back of the ankle. Inflamed tissue is removed at the time of the operation through the same incision.

Surgical Technique

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The procedure involves making an incision directly ‘bony bump’ at the back of the heel. The achilles tendon is partially reflected from its insertion into the calcaneus (heel bone). Any diseased portions of the tendon are removed. The excessive bony bump is removed, as is the inflamed bursa. The achilles tendon is secure back to the calcaneus with strong suture anchors.

 

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Recovery and Rehabilitation

What you need to know

We use surgical techniques that allow for early mobility and weight bearing. Weight bearing is commenced immediately with the addition of a postoperative boot. Depending on any other risk factors that may be present, patients are typically commenced on aspirin to reduce the risk of developing a blood clot. A wound review is performed 2 weeks following surgery, and a structured rehabilitation program is commenced with the support of dedicated sports physiotherapists. Progressive range of motion exercises and a strengthening program is initiated.

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Orthopaedics 360

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Orthopaedics 360

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