Surgical Treatment of Bony Insertional Achilles Tendinopathy and Haglund Deformity by a Modified Lateral Approach

Abstract: Insertional Achilles tendinopathy is a debilitating condition that is often recalcitrant and fails nonoperative treatment. Herein, we describe our surgical technique for treating this condition. We employ a lateral approach that elevates the tendon as one rather than the traditional midline tendon splitting approach. This allows complete access for thorough debridement of the tendon and excision of the associated Haglund exostosis and superficial enthesophyte. The tendon is repaired back to the calcaneus with a double-row repair, which allows patients to be functionally rehabilitated early. Gastrocnemius-soleus recession and platelet-rich plasma are added as necessary as adjunctive procedures. Level of Evidence: Level V.