Minimally Invasive Surgery for Chronic Achilles Tendinitis (Zadek Osteotomy)
The Achilles Tendon Insertion and the Inflamed Heel: What is it?
The Achilles tendon attaches to the heel bone (the calcaneus) over a very broad area. Although the tendon is only approximately one-centimeter thick, it's attachment spreads over a three and a half-centimeter area on the calcaneus.
Recurrent stress on the tendon where it attaches (the insertion) leads to inflammation, microscopic tearing of the tendon, swelling, and pain.
This swelling can be associated with inflammation of the space between the tendon and the calcaneus, called the retrocalcaneal bursa. At times the back of the heel can begin to enlarge and get quite thick.
Treatment of the insertion of Achilles tendonitis commences with rest, elevation of the heel on the sole of the shoe, and physical therapy treatments. All of these are designed to decrease the inflammation on the tendon that occurs when walking since this stretches the Achilles tendon.
Achilles Tendonitis Surgery Recovery - General Facts
- The surgery is performed as an outpatient procedure
- The procedure is minimally invasive through 2 small incisions
- Following surgery, you will need to use crutches for two weeks
- Driving is permitted at one week if it is the left foot, and at about 1 month if the right
- At the first office visit, you will be able to start walking in a removable walking boot
- The boot is worn for 6 weeks, and then you are able to wear a shoe
- The shoe should have an open back to prevent rubbing on the heel and tendon. You will be better with this shoe for about one month.
- Physical therapy is an important part of your recovery and starts at 2-4 weeks
- You can expect swelling and tenderness at the back of the heel for about 6-12 months after surgery
Achilles Tendonitis Surgery - Specific Post-Operative Course
- Foot wrapped in a bulky bandage
- Ice and elevate the foot
- Take pain medication
- Bloody drainage through bandage expected
- Do not change bandage
- Do not change the dressing
- First follow-up in the office
- X-rays taken
- Dressing changed, sutures are removed
- Boot is applied to the foot
- Weight-bearing in the boot as tolerated
- You may drive if the left foot is involved
- The boot is removed
- Stretching exercises are begun
- Physical therapy is important
- You can do a lot of the therapy yourself each day
- Wear an open heel shoe for one month