Case Reports and SeriesAchilles Tendon Reattachment after Surgical Treatment of Insertional Tendinosis Using the Suture Bridge Technique: A Case Series
Section snippets
Patients and Methods
We retrospectively reviewed the charts of patients with insertional Achilles tendinopathy who underwent surgical correction of Achilles tendinosis with complete detachment of the Achilles tendon and subsequent reattachment with the Arthrex SutureBridge® device from August 2009 to May 2010. A total of 4 patients with 4 surgical procedures were identified. Before surgical treatment of insertional Achilles tendinosis, each patient underwent conservative therapy and had weightbearing
Case 1
A 59-year-old woman presented to the clinic with a chief complaint of worsening right posterior heel pain and deformity for 2 years’ duration. The patient had attempted a course of physical therapy and nonsteroidal antiinflammatory medications without alleviation of her posterior heel discomfort. On physical examination, the patient had tenderness to palpation over the insertion site of the Achilles tendon onto the calcaneus. Furthermore, on visual and palpatory examination the patient had an
Results
Upon chart review, all patients initially presented with a chief complaint of posterior heel pain that failed conservative treatment. Weightbearing anteroposterior and lateral radiographs of the affected foot were reviewed, which demonstrated a posterosuperior calcaneal exostosis in all patients. In addition, one patient had intratendonous calcifications on radiographic examination. An MRI was performed on all patients and showed insertional Achilles tendinopathy and retrocalcaneal bursitis.
Discussion
Evidence supports surgical treatment of insertional Achilles tendinosis for those patients failing 3 to 6 months of conservative therapy. Research demonstrates excision of the retrocalcaneal bursa, ostectomy of the calcaneal exostosis and debridement of the degenerative and/or calcific Achilles tendon results in improved patient symptoms and function. However, there is a disagreement amongst surgeons concerning the amount of Achilles tendon detachment necessary to adequately debride the tendon
References (12)
Insertional Achilles tendinosis: pathogenesis and treatment
Foot Ankle Clin
(2009)- et al.
Surgical correction of Haglund’s triad using complete detachment and reattachment of the Achilles tendon
J Foot Ankle Surg
(2009) - et al.
Current concepts review: noninsertional Achilles tendinopathy
Foot Ankle Int
(2009) - et al.
Calcific insertional Achilles tendinopathy: reattachment with bone anchors
Am J Sports Med
(2004) Current concepts review: insertional Achilles tendinopathy
Foot Ankle Int
(2010)- et al.
Surgical strategies: insertional Achilles tendinopathy
Foot Ankle Int
(2008)
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Financial Disclosure: None reported.
Conflict of Interest: None reported.