Surgical Strategies for the Treatment of Insertional Achilles Tendinopathy

Insertional Achilles tendinopathy is one of the most common Achilles tendon disorders and often results in substantial heel pain and functional disability. There is consensus that treatment of insertional Achilles tendinopathy should start with nonoperative modalities. Surgery should be reserved for patients who fail exhaustive conservative treatment for a period of 3 months to 6 months and include débridement of insertional calcifications. Intratendinous degenerative tissue should be débrided and any Haglund deformity resected. Different surgical techniques have been described for reattachment of the distal Achilles tendon. The authors' preferred surgical technique includes the knotless double-row footprint reconstruction. Postoperative complications are not rare.