Achilles Tendinitis: Bone Spur Removal and Open Achilles Tendon Repair Animation

Achilles Tendinitis: Bone Spur Removal and Open Achilles Tendon Repair Animation

This animation demonstrates a bone spur removal and open Achilles tendon repair for the treatment of Achilles tendinitis. Here, we see a right foot with the Achilles tendon attached to the heel bone. There is a large bone spur, called a Haglund's deformity, at the top of the heel bone that is irritating the Achilles tendon.

First, an incision is made along the back of the heel to access the Achilles tendon. The Achilles tendon is cut through down to the heel bone, leaving the sides of the tendon attached. A saw is used to remove the bone spur at the back of the heel bone.

Next, a drill is positioned through a drill guide to create 2 holes in the bottom of the heel bone. An instrument called a tap is then used to widen the holes. A guide is then positioned over the area of removed bone. A soft body anchor is inserted into the bone through the guide and tapped into place. This anchor is already threaded with several strands of sutures. Tension is applied to the sutures to make sure that the anchor is secured into the bone. The same steps are repeated to insert another anchor.

The curved needle attached to the connected flat support sutures from 1 anchor is threaded through the side of the Achilles tendon. The same is repeated for the other side.

Each needle is then cut off from each pair of sutures, creating 4 separate strands. The other sutures from 1 anchor are then passed through the wire loop at the end of another curved needle, which is used to pass the sutures through the side of the Achilles tendon. The same is repeated for the other side.

The white suture from 1 anchor is placed through the loop of the striped suture from the other anchor, and the striped suture is pulled to create a suture bridge across the tendon. The same steps are repeated for the other white and striped sutures. Tension is applied to the sutures to pull the sides of the Achilles tendon closer together and down toward the heel bone.

Then, 1 strand of flat support suture from each of the already placed anchors is threaded through the tip of a hard-body anchor. This anchor is inserted into 1 of the drilled holes in the heel bone and tapped into place. The same steps are repeated for another anchor.

The ends of the flat support sutures are cut off, and additional small sutures are used to stitch together the cut made in the Achilles tendon. The skin incision is closed with additional sutures, and a wound dressing will be placed over the skin. The bone spur removal and open Achilles tendon repair is now complete.