The Foot and Ankle Clinic

Achilles Tendonosis

What is achilles tendonitis? | What does achilles tendonitis look like? | Insertional problems of the achilles | Symptoms of achilles tendonitis | Causes of achilles tendonitis | Treatments for achilles tendonitis | Physiotherapy for achilles tendonitis | Orthotic for achilles tendonitis | How soon should non-operative treatment of achilles tendonitis improve symptoms? | Injecting achilles tendonitis | What if achilles tendonitis fails to settle despite injection? | The surgical treatment of achilles tendonosis | What is the rationale behind the operations? | Achilles paratenon stripping and tendon incision - operative stills | Post operative course following achilles tendonitis surgical treatment | Complications following debridement of achilles tendonitis/tendonosis | Operative gallery for flexor hallucis longus tendon transfer | Post-operative course after flexor hallucis longus tendon transfer | Complications following a flexor hallucis longus transfer | What is a Hagglunds deformity? | What Is insertional tendonosis of the achilles? | Treatment for Hagglunds deformity/or insertional achilles tendonosis | Non-operative treatment of Hagglunds deformity, achilles tendonosis | Operative management of Hagglunds deformity and insertional achilles tendonosis


The Surgical Treatment of Achilles Tendonosis

The surgical treatment of Achilles tendonosis



Following the MRI or ultrasound scan the extent of degenerative change will have been defined. The two main types of operative intervention for Achilles tendonosis are either a stripping of the outer sheath (paratenon) and longitudinal incisions into the tendon or a major debridement of large portions of the tendon and then reconstruction of the remaining tendon using a flexor hallucis longus tendon transfer.

What Is The Rationale Behind The Operations for Achilles Tendonosis?

In cases of Achilles tendonosis with more minor degrees of degeneration such areas of tendon can be stimulated to repair themselves by incising the tendon, in the line of the fibres, which stimulates an ingrowth of blood vessels and results in the healing response.

To view a surgeonís operative manual, go to The Foot Surgery Atlas


With severe Achilles tendonosis, if a large area of painful tendon needs to be excised then a large defect is left. This defect needs to be filled and this is best done by transferring the flexor hallucis longus muscle belly and tendon, which is adjacent to the Achilles tendon.

Operation for Achilles Tendonosis

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