Achilles Tendinopathies of the Foot and Ankle


Noninsertional Achilles tendinopathies are often related to overuse. Paratendonitis frequently occurs in active 20- to 30-year-old athletes involved in high impact activities. Tendinosis most often occurs as a degenerative process in middle-aged individuals.

Insertional tendinopathies have a bimodal distribution. They tend to occur most often in adults in their forties and fifties, often in obese patients as a result of tendon degeneration. Insertional tendinopathy can also develop in young athletic individuals, but this occurs far less commonly than noninsertional disease.

Achilles tendinopathy is also found in patients of all ages afflicted with medical conditions such as diabetes, systemic enthesopathies, or chronic renal failure.

This topic reviews the clinical presentation, nonsurgical options, and surgical techniques for management of noninsertional tendinopathies, including Achilles tendon débridement and flexor hallucis tendon transfer.

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