Posterior heel pain (retrocalcaneal bursitis, insertional and noninsertional Achilles tendinopathy).
The majority of patients with Achilles tendinopathy respond to nonoperative treatment. In patients with refractory symptoms, surgery can be considered. If paratenonitis is present, the paratenon is partially excised, and adhesions are released. Areas of symptomatic tendinosis are excised with repair of the residual defect in the Achilles tendon. An alternative for patients with tendinosis who are at increased risk for wound problems or who do not want a large open incision is percutaneous or endoscopic tenotomy. A symptomatic Haglund's deformity or inflamed retrocalcaneal bursa is excised. Augmentation of the Achilles tendon may be considered if debridement threatens the structural integrity of the tendon, in older patients, and in revision surgery.
Aronow
Michael S
MS
Department of Orthopaedic Surgery, The University of Connecticut School of Medicine, 10 Talcott Notch, MC 4037, Farmington, CT 06034-4037, USA. aronow@nso.uchc.edu
D000125:Achilles Tendon / Q000601:surgery*; D002062:Bursitis / Q000601:surgery*; D006365:Heel; D006801:Humans; D009140:Musculoskeletal Diseases / Q000145:classification / Q000150:complications / Q000601:surgery*; D010146:Pain / Q000209:etiology*; D011183:Postoperative Complications; D013709:Tendon Transfer / Q000379:methods