Achilles tendinosis: treatment options

Abstract

Athletes usually complain of an ongoing or chronic pain over the Achilles tendon, but recently even non-athletes are experiencing the same kind of pain which affects their daily activities. Achilles tendinosis refers to a degenerative process of the tendon without histologic or clinical signs of intratendinous inflammation. Treatment is based on whether to stimulate or prevent neovascularization. Thus, until now, there is no consensus as to the best treatment for this condition. This paper aims to review the common ways of treating this condition from the conservative to the surgical options.

Keywords: Achilles tendon; Pain management; Surgical procedures; Tendinopathy.

Fig. 1

Use of extracorporeal shockwave therapy on Achilles tendinosis patient.

Fig. 2

Platelet rich plasma prepared from autologous blood of the patient.

Fig. 3

Schematic representation of a percutaneous longitudinal tenotomy using a no. 11 blade.

Fig. 4

(A) Calcaneus with Haglund's deformity. (B) Haglund's deformity excised and the Achilles tendon re-attached with suture anchor.

Fig. 5

Excision of diseased portion of the Achilles tendon with augmentation of the flexor hallucis longus.