Insertional Achilles surgery may be considered for patients with persistent pain at the point where the Achilles tendon attaches to the heel bone, particularly when non-surgical treatment has not been successful. The aim of surgery is to reduce pain, address the underlying problem and improve function.
Mr Edward Dawe is a Consultant Foot & Ankle Surgeon specialising in the treatment of insertional Achilles problems, with a particular interest in minimally invasive surgery where appropriate. Clinics are available in Chichester, Worthing and Haywards Heath.
Most patients with insertional Achilles pain improve with non-surgical treatment. Surgery may be considered when symptoms persist despite an appropriate period of rehabilitation and continue to affect daily activities, walking or sport.
The decision to proceed with surgery depends on the severity of symptoms, the pattern of tendon and bone involvement and individual patient goals.
Minimally invasive surgery may be appropriate in selected patients with insertional Achilles pathology. These techniques aim to address the underlying problem while limiting soft tissue disruption.
Compared with more extensive open procedures, minimally invasive techniques may offer a more straightforward recovery in appropriate cases, although recovery varies between individuals and depends on the procedure performed.
As with all surgical procedures, there are risks associated with minimally invasive surgery, and the most appropriate technique is determined following specialist assessment.
In some patients, pain at the back of the heel is related to a prominent area of bone, often referred to as a Haglund deformity. This may contribute to irritation of the Achilles tendon and surrounding tissues.
Minimally invasive Haglund excision may be considered in selected cases to address this bony prominence.
Zadek osteotomy is a procedure that may be considered in selected patients with insertional Achilles pain. It aims to alter the mechanics at the back of the heel and reduce stress at the tendon insertion.
The suitability of this procedure depends on the pattern of disease and individual patient factors.
Calf tightness is a common contributing factor in Achilles tendon conditions. Procedures such as proximal medial gastrocnemius release may be considered in selected patients to reduce tension in the calf muscle and Achilles tendon.
This may form part of the surgical management plan depending on the overall pattern of symptoms and examination findings.
Open surgical techniques are still appropriate in some cases, particularly where there is more extensive tendon degeneration or where a minimally invasive approach is not suitable.
The choice between minimally invasive and open surgery depends on the condition being treated and the overall treatment plan.
Recovery following insertional Achilles surgery is gradual and usually involves a structured rehabilitation programme.
The exact timeline depends on the procedure performed, whether bone or tendon surgery has been required and individual progress with rehabilitation.
If you have persistent pain at the back of the heel despite rehabilitation or symptoms that are affecting activity, specialist assessment can help determine whether surgical treatment may be appropriate.
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Goring Hall and
Nuffield Haywards Heath Private secretary: Nicole Murray Tel: 07856 521034 [email protected] |
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