|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 | Shockwave Treatment | How soon should non-operative treatment of achilles tendonitis improve symptoms? | Imaging of the Achilles Tendon I Injecting achilles tendonitis | The surgical treatment of achilles tendonosis | What is the rationale behind the operations? | Post operative course following achilles tendonitis surgical treatment | Achilles Rupture | Return to normal activity after Achilles Tendon surgery | What is a Haglunds deformity? | What Is insertional tendonosis of the achilles? | Treatment for Haglunds deformity/or insertional achilles tendonosis | Non-operative treatment of Haglunds deformity, achilles tendonosis | Operative management of Haglunds deformity and insertional achilles tendonosis|
The Surgical Treatment of Achilles Tendonosis
Following the MRI or ultrasound scan of the Achilles tendon the extent of the degenerative change would have been defined. The two main types of operation for Achilles tendinosis are either a stripping of the outer sheath (paratenon) and longitudinal incisions into the tendon (known as a debridement) or a major excision of large portions of the tendon, the defects thus created then being reconstructed using either allograft (donor tendon, such as Wright medical graft jacket) or more commonly 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 degenerative change the areas can be stimulated to repair itself 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 in depth surgical pictures of Achilles Debridement go to The Foot Surgery Atlas.
With severe Achilles tendonosis, occasionally a large area of painful tendon needs to be excised which then produces a defect which requires filling. This is best done by transferring the flexor hallucis longus muscle belly and tendon, which lies adjacent to the Achilles tendon. This results in a composite/double tendon after the operation, with little deficit from the transferred tendon.
To view in depth surgical pictures of the Flexor Hallucis Transfer, go to The Foot Surgery Atlas.
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