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Surgical Treatment of Achilles Tendinitis by Decompression of the Retrocalcaneal Bursa and the Superior Calcaneal Tuberosity

Marilyn L. Yodlowski, MD, PhD, Arnold D. Scheller, Jr., MD^,, and Lampros Minos, PAC

Sports Medicine Service, Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts
ProSports Orthopedics, Waltham, Massachusetts

Presented at the 24th annual meeting of the AOSSM, Vancouver, British Columbia, Canada, July 1998.

Address correspondence and reprint requests to Arnold D. Scheller, Jr., MD, ProSports Orthopedics, 840 Winter Street, Waltham, MA 02451

Background: Initial nonoperative treatment of pain at the Achilles tendon, often referred to as "tendinitis," is not always successful.

Hypothesis: Surgical treatment is effective for patients with insertional tendinitis unrelieved by nonoperative measures.

Study Design: Retrospective cohort study.

Methods: Thirty-five patients (41 feet) who had painful Achilles tendon syndrome unrelieved by 6 months of nonoperative measures were treated surgically. The technique consisted of a single incision along the lateral border of the Achilles tendon. The dissection exposed the retrocalcaneal bursa and fat pad, which were completely excised along with any scarred and thickened paratenon. A partial calcaneal exostectomy of the tubercle was performed.

Results: At a minimum follow-up of 20 months (average, 39), the patients’ pain scores (rated from 0 to 6) improved from 4.7 (SD, 1.1) preoperatively to 1.5 (SD, 1.3); 90% had complete or significant relief of symptoms, 10% felt improved, and none felt unchanged or worse.

Conclusions: Surgical treatment of chronic Achilles tendon pain with resection of the prominent tuberosity, complete debridement of the bursa, excision of thickened, scarred paratenon, and removal of accessible calcific deposits within the tendon is an effective treatment.

This article has been cited by other articles:

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				M. Paavola, P. Kannus, T. A.H. Jarvinen, K. Khan, L. Józsa, and M. Jarvinen Achilles Tendinopathy J. Bone Joint Surg. Am., December 4, 2002; 84(11): 2062 - 2076. [Full Text] [PDF]