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Achilles Tendinopathy Surgery

Fortunately majority of Achilles Tendinopathy problems can be resolved with simple fomentation and stretching exercises. In some who do not heal with exercise based treatment, a PRP injection can do the needful. In a small minority of people with achilles tendinopathy, none of these treatments work. In those, underlying reason for the same need to be understood so that appropriate arthroscopic surgical procedure can be undertaken. 

Diagnosis

In patients with no respite with conservative management, an x-ray is necessary to understand the underlying pathology.

X-ray. X-ray helps to understand about the bone spurs, Haglund deformity (Prominent heel bone rubbing the Achilles tendon) and the swelling around that area.  

MRI Scan. MRI Scan may not always be necessary. However, this can help us to understand the condition of the retrocalcaneal bursa (fluid filled pouch) with greater detail. 

 

Treatment

Heat therapy followed by Foot and Achilles stretches twice a day for 4-6 weeks. 

If poor improvement PRP Injection to Achilles tendon.

Achilles Tendinopathy Arthroscopic Surgery

  • Achilles tendinopathy arthroscopic surgery is a day care surgery.

  • In prone position, small cuts are made to insert the camera through. On either side of the achilles tendon camera on one side and the instruments through the other side are inserted. 

  • The prominent part of the Haglund deformity is shaved off using the bone burr. The ankle movements are performed and checked for the bone beak.

  • Tendon debridement is performed and calcium deposits are removed. 

  • The thickened bursal tissue is debrided. 

  • The tendon is checked and adhesions are released using smooth PDS sutures taken through both sides of the tendon in the front and back of the tendon. 

  • Post this PRP injection may be used for healing of the tendon tissue.

 

Achilles Tendinopathy Surgery Rehabilitation

Post-surgery you can expect to be in a bulky dressing with Crepe bandage for 4 days. Early mobilization is recommended. You will be doing stretching exercises from second week. You will be allowed to start outdoor walking after 2 weeks post surgery. Jogging is typically started after 4 weeks post surgery. Return to most sporting activities is expected by 3 months. 

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