Achilles tendinopathy Part 2: Surgical management

Abstract

Although non-surgical management is the mainstay of treatment for non-insertional Achilles tendinopathy, many patients fail to respond to conservative measures. If symptoms persist after an extended period of conservative management, usually at least six months, surgery should be considered. Classically, open surgery was performed with excision of the diseased areas of the tendon. Due to a high rate of complications, as much as 10%, less invasive surgical techniques have been developed and are widely employed with good surgical outcomes and far fewer complications. The reported success rates of open and minimally invasive surgery are comparable and range from 46-100%. Considering the significant morbidity associated with open surgery, minimally invasive surgery is recommended as initial intervention, followed by open surgery if symptoms persist.