Open debridement of noninsertional achilles tendinopathy
Although symptomatic Achilles tendinopathy can be managed nonoperatively (Ohberg and Alfredson, Knee Surg Sports Traumatol Arthrosc 12:(5)465-70, 2004, Ohberg et al., Br J Sports Med 38(1):8-11, 2004), histologic analysis of tissue obtained at the time of surgery demonstrates degenerative fibrous tissue, no inflammatory cells, and no healing response (Astrom and Rausing, Clin Orthop Rel Res 316:151-64,1995, Maffulli and Kader J Bone Joint Surg (Br) 84(1):1-8). Surgical management of noninsertional Achilles tendinopathy is indicated when nonoperative management fails. Surgical options for noninsertional Achilles tendinopathy include the following: Percutaneous tenotomy; Tenosynovectomy. Open Achilles debridement with repair of the residual Achilles tendon. Open Achilles debridement with reconstruction of the residual Achilles tendon.
