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Updated: Aug 5, 2026
03:50
A Treatment Protocol for Achilles Tendinopathy with Extracorporeal Shockwave Therapy
Published on: August 2, 2024
Operative Management of Noninsertional Tendinosis: Indications and Current Treatment
Heidi C Ventresca1, Harley T Davis2, J Benjamin Jackson3
1Department of Orthopaedic Surgery, University of South Carolina, Columbia, SC, USA.
Foot and Ankle Clinics
|July 31, 2026
Summary
Noninsertional Achilles tendinopathy, a degenerative condition, often requires surgery when nonoperative treatments fail. Surgical outcomes are comparable between open and minimally invasive methods, but individualized approaches are recommended due to unclear pathophysiology.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanical Engineering
Background:
- Noninsertional Achilles tendinopathy results from chronic mechanical overload, frequently impacting athletes.
- Despite nonoperative management, around one-third of patients necessitate surgical intervention.
- Current understanding of the condition's pathophysiology is incomplete, hindering standardized treatment protocols.
Purpose of the Study:
- To review current surgical strategies for noninsertional Achilles tendinopathy.
- To compare outcomes of different surgical techniques, including open and minimally invasive approaches.
- To highlight the need for individualized surgical plans and future research directions.
Main Methods:
- Review of existing literature on surgical treatments for noninsertional Achilles tendinopathy.
- Analysis of reported outcomes for various procedures such as debridement, tendon scraping, paratenon release, and flexor hallucis longus transfer.
- Comparison of results between open and minimally invasive surgical techniques.
Main Results:
- Open and minimally invasive surgical techniques demonstrate comparable clinical outcomes.
- A range of surgical options are available, including debridement, tendon scraping, paratenon release, and flexor hallucis longus transfer.
- High-quality comparative studies are limited, indicating a need for further research.
Conclusions:
- Individualized surgical treatment selection is crucial, considering patient-specific factors and surgeon experience.
- Standardization of surgical management is challenging due to the unclear pathophysiology of the condition.
- Future research focusing on histopathological findings and clinical outcomes may improve treatment strategies for Achilles tendinopathy.
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