Minimally invasive surgeries for insertional Achilles tendinopathy: A commentary review

Abstract

Studies of minimally invasive surgery for insertional Achilles tendinopathy are limited. To establish this surgery, the following techniques must be minimally invasive: Exostosis resection at the Achilles tendon insertion, debridement of degenerated Achilles tendon, reattachment using anchors or augmentation using flexor hallucis longus (FHL) tendon transfer, and excision of the posterosuperior calcaneal prominence. Studies on these four perspectives were reviewed to establish minimally invasive surgery for insertional Achilles tendinopathy. Techniques for exostosis resection were demonstrated in one case study, where blunt dissection around the exostosis was performed, and the exostosis was resected using an abrasion burr under fluoroscopic guidance. Techniques for debridement of degenerated Achilles tendon were demonstrated in the same case study, where the space left after resection of the exostosis was used as an endoscopic working space, and the degenerated Achilles tendon and intra-tendinous calcification were debrided endoscopically. Achilles tendon reattachment techniques using suture anchors have been demonstrated in several studies. However, there are no studies on FHL tendon transfer techniques for Achilles tendon reattachment. In contrast, endoscopic posterosuperior calcaneal prominence resection is already established. Additionally, studies on ultrasound-guided surgeries and percutaneous dorsal wedge calcaneal osteotomy as minimally invasive surgery were reviewed.

Bi-portal Endoscopic Calcaneoplasty for Haglund's Deformity

“…In this article, we will explore the clinical and radiological outcomes of bi-portal endoscopic calcaneoplasty in the management of Haglund's deformity [6].…”

Kinesiophobia contributes to worse functional and patient‐reported outcome measures in Achilles tendinopathy: a systematic review

“…Achilles tendon disorders can be divided into two categories: acute ruptures and chronic overuse injuries [12]. Achilles tendinopathy (AT) is a chronic overuse injury characterized by progressive degeneration and impaired healing that causes pain in the tendon, often presenting in overweight middle‐aged patients [12, 14, 25, 33]. The incidence rate of AT is 2.35 per 1000 in the adult population and often occurs in individuals who have recently changed their physical activity [10].…”