Achilles tendon ruptures, re rupture with revision surgery, tendinosis, and insertional disease

Achilles tendon pathology is one of the more common conditions encountered by the foot and ankle surgeon. While it most frequently affects the athletic population, it can also lead to significant morbidity in the older and sedentary patient. The etiology of Achilles tendon dysfunction is multifactorial and has been found to be associated with overuse injury, training error, malalignment of the lower extremity, inflammatory disorders, and intrinsic disease or degeneration. Achilles tendon disorders have been classified temporally as acute and chronic, with the later subdivided into insertional and non-insertional (intrinsic) involvement. Histopathology has contributed a great deal to the understanding of disease process. Classification systems have been developed in an attempt to determine methods of treatment and prognosis. This article reviews the clinical spectrum of disease and presents contemporary treatment options.