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
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
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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