Achilles Tendinosis
The Achilles tendon is the largest and strongest tendon in the human body. It is a very important tendon in normal gait (walking). Over time the tendon can wear out, in particular with frequent running/jumping activities, weight gain or increasing age. Degeneration of the Achilles tendon can occur close to the middle of the tendon or at its insertion into the heel bone. Non-operative management is often very effective at reducing or eliminating symptoms and this comprises of Achilles stretching exercises and a heel lift orthotic.
Surgical management is reserved for patients who have tried the non-operative management without success. Surgery can comprise of tendon debridement, tendon transfer and debridement of bony prominences, which irritate the tendon close to its insertion.
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![Achilles Tendinosis - Victorian Orthopaedic Foot & Ankle Clinic](images/achilles-tendinosis-image-victorian-orthopaedic-foot-ankle-clinic.jpg)
This photo illustrates the typical location of a (Haglund's) bony prominence related to insertional Achilles tendinosis. This bump can rub in shoes and can occasionally be painful. |
![Achilles Tendinosis - X-ray - Victorian Orthopaedic Foot & Ankle Clinic](images/achilles-tendinosis-x-ray-image-victorian-orthopaedic-foot-ankle-clinic.jpg)
X-ray demonstrating the bony prominence as well calcium deposits in the Achilles tendon indicating some inflammation |
![Intra Pre Operative - Achilles Tendinosis - Victorian Orthopaedic Foot & Ankle Clinic](images/intra-pre-operative-achilles-tendinosis-image-victorian-orthopaedic-foot-ankle-clinic.jpg)
Picture of a degenerate and partially ruptured Achilles tendon. Note the swollen tendon which indicates longstanding tendon pathology |
![Intra Post Operative - Achilles Tendinosis - Victorian Orthopaedic Foot & Ankle Clinic](images/intra-post-operative-achilles-tendinosis-image-victorian-orthopaedic-foot-ankle-clinic.jpg)
Repair and reconstruction of the worn Achilles tendon. Incorporation of another (strong) tendon into the repair is sometimes required to augment a severely diseased Achilles. |
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