Achilles Tendoscopy and Endoscopic Procedures for Pathologies of the Achilles Tendon

  • Alastair Younger
  • Thomas S. Roukis
  • Ho Lam Chai
  • Tun Hing Lui
  • Mahmut Nedim Doral
  • Gazi Huri
  • Naila Babayeva
  • Egemen Turhan
  • Gürhan Dönmez
  • Charles Churk Hang Li
  • E. Rabat
  • J. Torrent
  • M. Bernaus
  • Wai Chung Chan


Endoscopic calcaneoplasty allows removal of impinging bone from the anterior side of the Achilles tendon, as well as removal of an inflamed bursa [1]. The posterior Achilles incision is at risk for wound breakdown, so the utilization of an arthroscopic approach will reduce the size of the incision and hopefully reduce the risk of wound complications. The prone position is preferred [2, 3].



Many thanks to Dr. Sally H. S. Cheng for her contribution to the drawing of Fig. 14.62c, d.


  1. 1.
    Jerosch J. Endoscopic calcaneoplasty. Foot Ankle Clin. 2015;20:149–65.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Labib SA, Pendleton AM. Endoscopic calcaneoplasty: an improved technique. J Surg Orthop Adv. 2012;21:176–80.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Scholten PE, van Dijk CN. Endoscopic calcaneoplasty. Foot Ankle Clin. 2006;11:439–46, viii.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Lui TH. Retrocalcaneal pain after open reduction and internal fixation of avulsion fracture of the Achilles tendon treated by endoscopic adhesiolysis and endoscopic calcaneoplasty: a case report. Foot Ankle Spec. 2016;9:279–83.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Lui TH. Retrocalcaneal pain after the repair of acute Achilles tendon rupture. Foot Ankle Spec. 2013;6:323–7.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Kaynak G, Ogut T, Yontar NS, Botanlioglu H, Can A, Unlu MC. Endoscopic calcaneoplasty: 5-year results. Acta Orthop Traumatol Turc. 2013;47:261–5.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    van Sterkenburg MN, Groot M, Sierevelt IN, Spennacchio PA, Kerkhoffs GM, van Dijk CN. Optimization of portal placement for endoscopic calcaneoplasty. Arthroscopy. 2011;27:1110–7.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Painter CF. Inflammation of the post-calcaneal bursa associated with exostosis. Trans Am Orthop Assoc. 1898;1(1):169–80.Google Scholar
  9. 9.
    Paavola M, Orava S, Leppilahti J, et al. Chronic Achilles tendon overuse injury: complications after surgical treatment. An analysis of 432 consecutive patients. Am J Sports Med. 2000;28(1):77–82.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Benazzo F, Todesca A, Ceciliani L. Achilles tendon tendonitis and heel pain. Oper Tech Sports Med. 1997;4(3):179–88.CrossRefGoogle Scholar
  11. 11.
    Chao W, Deland JT, Bates JE, et al. Achilles tendon insertion: an in vitro anatomic study. Foot Ankle Int. 1997;18(2):81–4.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Milz S, Rufai A, Buettner A, et al. Three-dimensional reconstructions of the Achilles tendon insertion in man. J Anat. 2002;200(2):145–52.PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Kachlik D, Baca V, Cepelik M, et al. Clinical anatomy of the calcaneal tuberosity. Ann Anat. 2008;190(3):284–91.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Lohrer H, Arentz S, Nauck T, et al. The Achilles tendon insertion is crescent-shaped: an in vitro anatomic investigation. Clin Orthop Relat Res. 2008;466(9):2230–7.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Sundararajan PP, Wilde TS. Radiographic, clinical, and magnetic resonance imaging analysis of insertional Achilles tendinopathy. J Foot Ankle Surg. 2014;53(2):147–51.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Frey C, Rosenberg Z, Shereff MJ, et al. The retrocalcaneal bursa: anatomy and bursography. Foot Ankle Int. 1992;13(4):203–7.CrossRefGoogle Scholar
  17. 17.
    Theobald P, Bydder G, Dent C, et al. The functional anatomy of Kager’s fat pad in relation to retrocalcaneal problems and other hindfoot disorders. J Anat. 2006;208(1):91–7.PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Irwin TA. Current concepts review: insertional Achilles tendinopathy. Foot Ankle Int. 2010;31(10):933–9.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Kim PJ, Richey JM, Wissman LR, et al. The variability of the Achilles tendon insertion: a cadaveric examination. J Foot Ankle Surg. 2010;49(5):417–20.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Merkel KHH, Hess H, Kunz M. Insertion tendinopathy in athletes. A light microscopic, histochemical and electron microscopic examination. Pathol Res Pract. 1982;173:303–9.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Astrom M, Rausing A. Chronic Achilles tendinopathy. A survey of surgical and histopathologic findings. Clin Orthop Relat Res. 1995;316:151–64.Google Scholar
  22. 22.
    de Palma L, Marinelli M, Memè L, et al. Immunohistochemistry of the enthesis organ of the human Achilles tendon. Foot Ankle Int. 2004;25(6):414–8.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Wiegerinck JI, Kerkhoffs GM, Van Sterkenburg MN, et al. Treatment for insertional Achilles tendinopathy: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2013;21(6):1345–55.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Sterkenburg MN, Leeuw PAJ, Dijk CN. Tendoscopy. In: Maffuli N, Easley M, editors. Minimally invasive surgery of the foot and ankle. London: Springer; 2011. p. 35–53.Google Scholar
  25. 25.
    Christensen JC, Lanier TD. Tendoscopy of the ankle. Clin Podiatr Med Surg. 2011;28(3):561–70.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Phisitkul P. Endoscopic surgery of the Achilles tendon. Curr Rev Muscoskelet Med. 2012;5(2):156–63.CrossRefGoogle Scholar
  27. 27.
    Cychosz CC, Phisitkul P, Barg A, et al. Foot and ankle tendoscopy: evidence-based recommendations. Arthroscopy. 2014;30(6):755–65.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Hsu WK, Mishra A, Rodeo SR, et al. Platelet-rich plasma in orthopaedic applications: evidence-based recommendations for treatment. J Am Acad Orthop Surg. 2013;21(12):739–48.PubMedPubMedCentralGoogle Scholar
  29. 29.
    Öhberg L, Alfredson H. Sclerosing therapy in chronic Achilles tendon insertional pain-results of a pilot study. Knee Surg Sports Traumatol Arthrosc. 2003;11(5):339–43.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Vulpiani MC, Trischitta D, Trovato P, et al. Extracorporeal shockwave therapy (ESWT) in Achilles tendinopathy. A long-term follow-up observational study. J Sports Med Phys Fitness. 2009;49(2):171–6.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Furia JP. High-energy extracorporeal shock wave therapy as a treatment for insertional Achilles tendinopathy. Am J Sports Med. 2006;34(5):733–40.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Lui TH. Arthroscopy and endoscopy of the foot and ankle: indications for new techniques. Arthroscopy. 2007;23(8):889–902.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Lehto MUK, Järvinen M, Suominen P. Chronic Achilles peritendinitis and retrocalcanear bursitis. Knee Surg Sports Traumatol Arthrosc. 1994;2(3):182–5.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Maffuli N, Testa V, Capasso G, et al. Calcific insertional Achilles tendinopathy: reattachment with bone anchors. Am J Sports Med. 2004;32(1):174–82.CrossRefGoogle Scholar
  35. 35.
    Paavola M, Paakkala T, Kannus P, et al. Ultrasonography in the differential diagnosis of Achilles tendon injuries and related disorders: a comparison between pre-operative ultrasonography and surgical findings. Acta Radiol. 1998;39(6):612–9.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Åström M, Gentz CF, Nilsson P, et al. Imaging in chronic Achilles tendinopathy: a comparison of ultrasonography, magnetic resonance imaging and surgical findings in 27 histologically verified cases. Skelet Radiol. 1996;25(7):615–20.CrossRefGoogle Scholar
  37. 37.
    Khan KM, Forster BB, Robinson J, et al. Are ultrasound and magnetic resonance imaging of value in assessment of Achilles tendon disorders? A two-year prospective study. Br J Sports Med. 2003;37(2):149–53.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Lui TH. Technique tip: reattachment of the Achilles tendon after endoscopic calcaneoplasty. Foot Ankle Int. 2007;28(6):742–5.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Maquirriain J. Endoscopic Achilles tenodesis: a surgical alternative for chronic insertional tendinopathy. Knee Surg Sports Traumatol Arthrosc. 2007;15(7):940–3.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Lui TH. Endoscopic assisted flexor hallucis tendon transfer in the management of chronic rupture of Achilles tendon. Knee Surg Sports Traumatol Arthrosc. 2007;15(9):1163–6.PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Calder JD, Saxby TS. Surgical treatment of insertional Achilles tendinosis. Foot Ankle Int. 2003;24(2):119–21.PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Vega J, Cabestany JM, Golanó P, et al. Endoscopic treatment for chronic Achilles tendinopathy. Foot Ankle Surg. 2008;14(4):204–10.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Leitze Z, Sella EJ, Aversa JM. Endoscopic decompression of the retrocalcaneal space. J Bone Joint Surg Am. 2003;85(8):1488–96.PubMedCrossRefPubMedCentralGoogle Scholar
  44. 44.
    Bohu Y, Lefèvre N, Bauer T, et al. Surgical treatment of Achilles tendinopathies in athletes. Multicenter retrospective series of open surgery and endoscopic techniques. Orthop Traumatol Surg Res. 2009;95((8):72–7.CrossRefGoogle Scholar
  45. 45.
    Almekinders LC, Temple JD. Etiology, diagnosis, and treatment of tendonitis: an analysis of the literature. Med Sci Sports Exerc. 1998;30(8):1183–90.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Waldecker U, Hofmann G, Drewitz S. Epidemiologic investigation of 1394 feet: conincidence of hindfoot malalignment and achilles tendon disorders. Foot Ankle Surg. 2012;18(2):119–23.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Li HY, Hua YH. Achilles tendinopathy: current concepts about the basic science and clinical treatments. Biomed Res Int. 2016;2016:1–9.Google Scholar
  48. 48.
    Paavola M, Kannus P, et al. Achilles tendinopathy. J Bone Joint Surg Am. 2002;84(11):2062–76.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Pearce CJ, Ismail M, Calder JD. Is apoptosis the cause of noninsertional achilles tendinopathy? Am J Sports Med. 2009;37(12):2440–4.PubMedCrossRefPubMedCentralGoogle Scholar
  50. 50.
    Longo UG, Ronga M, Maffulli N. Achilles tendinopathy. Sports Med Arthrosc Rev. 2009;17(2):112–26.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Alfredson H, Ohberg L. Sclerosing injections to areas of neo-vascularisation reduce pain in chronic Achilles tendinopathy: a double-blind randomised controlled trial. Knee Surg Sports Traumatol Arthrosc. 2005;13:338–44.PubMedCrossRefPubMedCentralGoogle Scholar
  52. 52.
    Ohberg L, Alfredson H. Effects on neovascularisation behind the good results with eccentric training in chronic mid-portion Achilles tendinosis? Knee Surg Sports Traumatol Arthrosc. 2004;12:465–70.PubMedCrossRefPubMedCentralGoogle Scholar
  53. 53.
    Steenstra F, van Dijk CN. Achilles tendonscopy. Foot Ankle Clin. 2006;11:429–38.PubMedCrossRefPubMedCentralGoogle Scholar
  54. 54.
    Pearce CJ, Carmichael J, Calder JD. Achilles tendinoscopy and plantaris tendon release and division in the treatment of non-insertional Achilles tendinopathy. Foot Ankle Surg. 2012;18:124–7.PubMedPubMedCentralCrossRefGoogle Scholar
  55. 55.
    Schepsis AA, Leach RE. Surgical management of Achilles tendinitis. Am J Sports Med. 1987;15:308–15.PubMedCrossRefPubMedCentralGoogle Scholar
  56. 56.
    Maquirriain J, Ayerza M. Endoscopic surgery in chronic Achilles tendinopathies: a preliminary report. Arthroscopy. 2002;18:298–303.PubMedCrossRefPubMedCentralGoogle Scholar
  57. 57.
    Thermann H, Benetos IS, et al. Endoscopic treatment of chronic mid-portion Achilles tendinopathy: novel technique with short-term results. Knee Surg Sports Traumatol Arthrosc. 2009;17:1264–9.PubMedCrossRefPubMedCentralGoogle Scholar
  58. 58.
    Lui TH. Endoscopic calcaneoplasty and Achilles tendoscopy with the patient in supine position. Arthrosc Tech. 2016;26:e1475–9.CrossRefGoogle Scholar
  59. 59.
    O’Brien M. The anatomy of the Achilles tendon. Foot Ankle Clin. 2005;10(2):225–38. Scholar
  60. 60.
    Standring S. Gray’s anatomy: the anatomical basis of clinical practice, 41st ed. Edinburgh: Elsevier; 2015, 1562p.Google Scholar
  61. 61.
    Asplund CA, Best TM. Achilles tendon disorders. BMJ. 2013;346:f1262. Scholar
  62. 62.
    Shaw HM, Vázquez OT, McGonagle D, Bydder G, Santer RM, Benjamin M. Development of the human Achilles tendon enthesis organ. J Anat. 2008;213(6):718–24. Scholar
  63. 63.
    Chen TM, Rozen WM, Pan W, Ashton MW, Richardson MD, Taylor GI. The arterial anatomy of the Achilles tendon: anatomical study and clinical implications. Clin Anat. 2009;22(3):377–85. Scholar
  64. 64.
    Suchak AA, Bostick G, Reid D, Blitz S, Jomha N. The incidence of Achilles tendon ruptures in Edmonton, Canada. Foot Ankle Int. 2005;26(11):932–6. Scholar
  65. 65.
    Maffulli N. Rupture of the Achilles tendon. J Bone Joint Surg Am. 1999;81(7):1019–36. Scholar
  66. 66.
    Hattrup SJ, Johnson KA. A review of ruptures of the Achilles tendon. Foot Ankle. 1985;6(1):34–8. Scholar
  67. 67.
    Wills CA, Washburn S, Caiozzo V, Prietto CA. Achilles tendon rupture. A review of the literature comparing surgical versus nonsurgical treatment. Clin Orthop Relat Res. 1986;207:156–63.
  68. 68.
    Wong J, Barrass V, Maffulli N. Quantitative review of operative and nonoperative management of achilles tendon ruptures. Am J Sports Med. 2002;30(4):565–75. Scholar
  69. 69.
    Kocher MS, Bishop J, Marshall R, Briggs KK, Hawkins RJ. Operative versus nonoperative management of acute Achilles tendon rupture: expected-value decision analysis. Am J Sports Med. 2002;30(6):783–90. Scholar
  70. 70.
    Lui TH. Surgical tip: repair of acute Achilles rupture with Krackow suture through a 1.5 cm medial wound. Foot Ankle Surg. 2010;16(1):28–31. Scholar
  71. 71.
    Tang K, Thermann H, Dai G, Chen G, Guo L, Yang L. Arthroscopically assisted percutaneous repair of fresh closed Achilles tendon rupture by Kessler’s suture. Am J Sports Med. 2007;35(4):589–96. Scholar
  72. 72.
    Halasi T, Tallay A, Berkes I. Percutaneous Achilles tendon repair with and without endoscopic control. Knee Surg Sports Traumatol Arthrosc. 2003;11(6):409–14. Scholar
  73. 73.
    Rebeccato A, Santini S, Salmaso G, Nogarin L. Repair of the Achilles tendon rupture: a functional comparison of three surgical techniques. J Foot Ankle Surg. 2001;40(4):188–94. Scholar
  74. 74.
    Kangas J, Pajala A, Siira P, Hämäläinen M, Leppilahti J. Early functional treatment versus early immobilization in tension of the musculotendinous unit after Achilles rupture repair. J Trauma. 2003;54(6):1171–80. Scholar
  75. 75.
    Mortensen HM, Skov O, Jensen PE. Early motion of the ankle after operative treatment of a rupture of the Achilles tendon. A prospective, randomized clinical and radiographic study. J Bone Joint Surg Am. 1999;81(7):983–90. Scholar
  76. 76.
    Buchgraber A, Pässler HH. Percutaneous repair of Achilles tendon rupture. Immobilization versus functional postoperative treatment. Clin Orthop Relat Res. 1997;341:113–22. Scholar
  77. 77.
    Doral MN, Alam M, Bozkurt M, et al. Functional anatomy of the Achilles tendon. Knee Surg Sports Traumatol Arthrosc. 2010;18(5):638–43. Scholar
  78. 78.
    Chan KB, Lui TH, Chan LK. Endoscopic-assisted repair of acute Achilles tendon rupture with Krackow suture: an anatomic study. Foot Ankle Surg. 2009;15(4):183–6. Scholar
  79. 79.
    El Shazly O, Abou ElSoud MM, Desouky A. Endosopic Achilles tendon augmentation with a graft loop anatomic and radiologic study. Foot Ankle Surg. 2011;17(3):173–7. Scholar
  80. 80.
    Huri G, Biçer ÖS, Özgözen L, Uçar Y, Garbis NG, Hyun YS. A novel repair method for the treatment of acute Achilles tendon rupture with minimally invasive approach using button implant: a biomechanical study. Foot Ankle Surg. 2013;19(4):261–6. Scholar
  81. 81.
    Doral MN, Huri G, Turhan E, Kaya D, Dönmez G. Endoscopy assisted percutaneous repair of Achilles tendon ruptures. Eur J Endosc Laparosc Surg. 2014;1(2):61–5.Google Scholar
  82. 82.
    Chiodo CP, Wilson MG. Current concepts review: acute ruptures of the Achilles tendon. Foot Ankle Int. 2006;27(4):305–15. Scholar
  83. 83.
    Liem MD, Zegel HG, Balduini FC, Turner ML, Becker JM, Caballero-Saez A. Repair of Achilles tendon ruptures with a polylactic acid implant: assessment with MR imaging. Am J Roentgenol. 1991;156(4):769–73. Scholar
  84. 84.
    Lim J, Dalai R, Waseem M. Percutaneous vs. open repair of the ruptured Achilles tendon—a prospective randomized controlled study. Foot Ankle Int. 2001;22(7):559–68. Scholar
  85. 85.
    Takao M, Ochi M, Naito K, Uchio Y, Matsusaki M, Oae K. Repair of neglected Achilles tendon rupture using gastrocnemius fascial flaps. Arch Orthop Trauma Surg. 2003;123(9):471–4. Scholar
  86. 86.
    Ma GW, Griffith TG. Percutaneous repair of acute closed ruptured Achilles tendon: a new technique. Clin Orthop Relat Res. 1977;128:247–55.
  87. 87.
    Thermann H, Tibesku CO, Mastrokalos DS, Pässler HH. Endoscopically assisted percutaneous Achilles tendon suture. Foot Ankle Int. 2001;22(2):158–60. Scholar
  88. 88.
    Doral MN, Bozkurt M, Turhan E, et al. Achilles tendon rupture: physiotherapy and endoscopy-assisted surgical treatment of a common sports injury. Open Access J Sports Med. 2010;1:233. Scholar
  89. 89.
    Cretnik A, Kosanovic M, Smrkolj V. Percutaneous versus open repair of the ruptured Achilles tendon: a comparative study. Am J Sports Med. 2005;33(9):1369–79. Scholar
  90. 90.
    Lui TH. Endoscopic adhesiolysis for extensive tibialis posterior tendon and Achilles tendon adhesions following compound tendon rupture. BMJ Case Rep. 2013;2013:bcr2013200824.PubMedPubMedCentralGoogle Scholar
  91. 91.
    Ahn J, Choy W. Tendon adhesion after percutaneous repair of the Achilles tendon: a case report. J Foot Ankle Surg. 2011;50(1):93–5.PubMedCrossRefPubMedCentralGoogle Scholar
  92. 92.
    Feldscher SL. Flexor tenolysis. Hand Surg. 2002;07(1):61–74.CrossRefGoogle Scholar
  93. 93.
    Lui TH. Endoscopic Achilles tenolysis for management of heel cord pain after repair of acute rupture of Achilles tendon. J Foot Ankle Surg. 2013;52(1):125–7.PubMedCrossRefPubMedCentralGoogle Scholar
  94. 94.
    Mandelbaum B, Myerson M, Forster R. Achilles tendon ruptures: a new method of repair, early range of motion, and functional rehabilitation. Am J Sports Med. 1995;23(4):392–5.PubMedCrossRefPubMedCentralGoogle Scholar
  95. 95.
    Calder J. Early, active rehabilitation following mini-open repair of Achilles tendon rupture: a prospective study. Br J Sports Med. 2005;39(11):857–9.PubMedPubMedCentralCrossRefGoogle Scholar
  96. 96.
    Lui TH. A case of heel cord pain after repair of acute Achilles tendon rupture. Foot Ankle Spec. 2016;9(5):448–51.PubMedCrossRefPubMedCentralGoogle Scholar
  97. 97.
    Strayer LM Jr. Recession of the gastrocnemius; an operation to relieve spastic contracture of the calf muscles. J Bone Joint Surg Am. 1950;32-A(3):671–6.PubMedCrossRefPubMedCentralGoogle Scholar
  98. 98.
    Silver CM, Simon SD. Gastrocnemius-muscle recession (Silfverskiold operation) for spastic equinus deformity in cerebral palsy. J Bone Joint Surg Am. 1959;41-A:1021–8.PubMedCrossRefPubMedCentralGoogle Scholar
  99. 99.
    Silfverskiold B. Reduction of the uncrossed to one joint muscles in spastic children. Acta Chir Scand. 1923;56:315–30.Google Scholar
  100. 100.
    Barouk LS. The effect of gastrocnemius tightness on the pathogenesis of juvenile hallux valgus: a preliminary study. Foot Ankle Clin. 2014;19(4):807–22.PubMedCrossRefPubMedCentralGoogle Scholar
  101. 101.
    Di Giovanni CW, Kuo R, Tejwani N, et al. Isolated gastrocnemius tightness. J Bone Joint Surg Am. 2002;84:962–70.CrossRefGoogle Scholar
  102. 102.
    Arandes R, Viladot A. Biomechanics of the calcaneus. Minerva Chir. 1954;39:439–46.Google Scholar
  103. 103.
    Rosenbloom AL, Silverstein JH. Connective tissue and joint disease in diabetes mellitus. Endocrinol Metab Clin N Am. 1996;25(2):473–83.CrossRefGoogle Scholar
  104. 104.
    Cychosz CC, Phisitkul P, Belatti DA, Glazebrook MA, DiGiovanni CW. Gastrocnemius recession for foot and ankle conditions in adults: evidence-based recommendations. Foot Ankle Surg. 2015;21(2):77–85.PubMedCrossRefPubMedCentralGoogle Scholar
  105. 105.
    Morales-Muñoz P, De Los Santos Real R, Barrio Sanz P, Pérez JL, Varas Navas J, Escalera Alonso J. Gastrocnemius proximal release in the treatment of mechanical metatarsalgia. Foot Ankle Int. 2016;37(7):782–9.PubMedCrossRefPubMedCentralGoogle Scholar
  106. 106.
    Molund M, Paulsrud Ø, Ellingsen Husebye E, Nilsen F, Hvaal K. Results after gastrocnemius recession in 73 patients. Foot Ankle Surg. 2014;20(4):272–5.PubMedCrossRefPubMedCentralGoogle Scholar
  107. 107.
    Vulpius O, Stoffel A. Tenotomie der end schnen der mm. Gastrocnemius el soleus mittels rutschenlassens nach vulpius. Stuttgart: Ferdinand Enke; 1913.Google Scholar
  108. 108.
    Pinney SJ, Sangeorzan BJ, Hansen ST Jr. Surgical anatomy of the gastrocnemius recession (Strayer procedure). Foot Ankle Int. 2004;25(4):247–50.PubMedCrossRefPubMedCentralGoogle Scholar
  109. 109.
    Colombier JA. Liberaton proximale pure dans la prise en charge thérapeu que des gastrocnemiens. Courts symposium “brieveté des gastrocnemiens”, journées de printemps SFMCP-AFCP, Toulouse. Med Chir Pied. 2006;22:156–7.Google Scholar
  110. 110.
    Barouk LS, Barouk P, Toulec E. Resulltats de la liberaton proximale des gastrocnemiens. Etude prospec ve symposium “brieveté des gastrocnemiens”, journées de printemps SFMCP-AFCP, Toulouse. Med Chir Pied. 2006;22:151–6.Google Scholar
  111. 111.
    Barouk LS. Gastrocnemius proximal release. In: Barouk LS, editor. Forefoot reconstruction. 2nd ed. Paris: Springer; 2005. p. 158–67.CrossRefGoogle Scholar
  112. 112.
    Barouk P. Technique, les indications et les résultats de l'allongement proximale du gastrocnémien. In: Barouk LS, Barouk P, editors. Gastrocnemius tightness: from anatomy to treatment. Paris: Sauramps Medical; 2012. p. 351–73.Google Scholar
  113. 113.
    Saxena A. Endoscopic gastrocnemius tenotomy. J Foot Ankle Surg. 2002;41(1):57–8.PubMedCrossRefPubMedCentralGoogle Scholar
  114. 114.
    Tashjian RZ, Appel AJ, Banerjee R, Digiovanni CW. Endoscopic gastrocnemius recession: evaluation in a cadaver model. Foot Ankle Int. 2003;24:607–13.PubMedCrossRefPubMedCentralGoogle Scholar
  115. 115.
    Saxena A, Widtfeldt A. Endoscopic gastrocnemius recession: preliminary report on 18 cases. Foot Ankle Surg. 2004;43:302–6.CrossRefGoogle Scholar
  116. 116.
    Trevino S, Gibbs M, Panchbhavi V. Evaluation of results of endoscopic gastrocnemius recession. Foot Ankle Int. 2005;26:359–64.PubMedCrossRefPubMedCentralGoogle Scholar
  117. 117.
    Carl T, Barrett SL. Cadaveric assessment of the gastrocnemius aponeurosis to assist in the pre-operative planning for two portal endoscopic gastrocnemius recession (EGR). Foot. 2005;15:137–40.CrossRefGoogle Scholar
  118. 118.
    Lui TH. Endoscopic gastrocnemius intramuscular aponeurotic recession. Arthrosc Tech. 2015;4(5):e615–8.PubMedPubMedCentralCrossRefGoogle Scholar
  119. 119.
    Delp SL, Statler K, Carroll NC. Preserving plantar flexion strength after surgical treatment for contracture of the triceps surae: a computer simulation study. J Orthop Res. 1995;13(1):96–104.PubMedCrossRefPubMedCentralGoogle Scholar
  120. 120.
    Cozen L. Effect of lengthening the Achilles tendon on the strength of gastrocnemius-soleus musculature. Clin Orthop Relat Res. 1966;49:179–90.PubMedCrossRefPubMedCentralGoogle Scholar
  121. 121.
    Chen L, Greisberg J. Achilles lengthening procedures. Foot Ankle Clin. 2009;14(4):627–37.PubMedCrossRefPubMedCentralGoogle Scholar
  122. 122.
    Firth GB, McMullan M, Chin T, et al. Lengthening of the gastrocnemius-soleus complex: an anatomical and biomechanical study in human cadavers. J Bone Joint Surg. 2013;95(16):1489–96.PubMedCrossRefPubMedCentralGoogle Scholar
  123. 123.
    Sammarco GJ, Bagwe MR, Sammarco VJ, et al. The effects of unilateral gastrocsoleus recession. Foot Ankle Int. 2006;27(7):508–11.PubMedCrossRefPubMedCentralGoogle Scholar
  124. 124.
    Chimera NJ, Castro M, Davis I, et al. The effect of isolated gastrocnemius contracture and gastrocnemius recession on lower extremity kinematics and kinetics during stance. Clin Biomech (Bristol, Avon). 2012;27(9):917–23.CrossRefGoogle Scholar
  125. 125.
    Hsu RY, VanValkenburg S, Tanriover A, DiGiovanni CW. Surgical techniques of gastrocnemius lengthening. Foot Ankle Clin. 2014;19(4):745–65.PubMedCrossRefPubMedCentralGoogle Scholar
  126. 126.
    Nawoczenski DA, Diliberto FE, Cantor MS, Tome JM, DiGiovanni BF. Ankle power and endurance outcomes following isolated gastrocnemius recession for Achilles tendinopathy. Foot Ankle Int. 2016;37:766.PubMedCrossRefPubMedCentralGoogle Scholar
  127. 127.
    Webb J, Moorjani N, Radford M. Anatomy of the sural nerve and its relation to the Achilles tendon. Foot Ankle Int. 2000;21:475–7.PubMedCrossRefPubMedCentralGoogle Scholar
  128. 128.
    Rabat E, Solana J. XVIII congress of SECMPT, Tenerife. Alargamiento Endoscopico del Gastrocnemio. 2008.Google Scholar
  129. 129.
    Rabat E. Endoscopic gastrocnemius recession. In: Barouk LS, Barouk P, editors. Gastrocnemius tightness: from anatomy to treatment. Paris: Sauramps Medical; 2012. p. 351–73.Google Scholar
  130. 130.
    McGlamry ED, Banks AS. McGlamry’s comprehensive textbook of foot and ankle surgery. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 722.Google Scholar
  131. 131.
    Meszaros A, Caudell G. The surgical management of equinus in the adult acquired flatfoot. Clin Podiatr Med Surg. 2007;24:667–85. Scholar
  132. 132.
    Cohen JC. Anatomy and biomechanical aspects of the gastrocsoleus complex. Foot Ankle Clin. 2009;14:617–26. Scholar
  133. 133.
    Blitz NM, Eliot DJ. Anatomical aspects of the gastrocnemius aponeurosis and its muscular bound portion: a cadaveric study—part II. J Foot Ankle Surg. 2008;47:533–40.PubMedCrossRefPubMedCentralGoogle Scholar
  134. 134.
    Angthong C, Kanitnate S. Dual-portal endoscopic gastrocnemius recession for the treatment of severe posttraumatic equinus deformity: a case series and a review of technical modifications. J Nippon Med Sch. 2012;79:198–203.PubMedCrossRefPubMedCentralGoogle Scholar
  135. 135.
    Barrett SL, Jarvis J. Equinus deformity as a factor in forefoot nerve entrapment: treatment with endoscopic gastrocnemius recession. J Am Podiatr Med Assoc. 2005;95:464–8.PubMedCrossRefPubMedCentralGoogle Scholar
  136. 136.
    DiDomenico LA, Adams HB, Garchar D. Endoscopic gastrocnemius recession for the treatment of gastrocnemius equinus. J Am Podiatr Med Assoc. 2005;95:410–3.PubMedCrossRefPubMedCentralGoogle Scholar
  137. 137.
    Poul J, Tuma J, Bajerova J. Video-assisted gastrocnemius-soleus and hamstring lengthening in cerebral palsy patients. J Pediatr Orthop B. 2008;17:81–4.PubMedCrossRefPubMedCentralGoogle Scholar
  138. 138.
    Roukis TS, Schweinberger MH. Complications associated with uni-portal endoscopic gastrocnemius recession in a diabetic patient population: an observational case series. J Foot Ankle Surg. 2010;49:68–70.PubMedCrossRefPubMedCentralGoogle Scholar
  139. 139.
    Schroeder SM. Uniportal endoscopic gastrocnemius recession for treatment of gastrocnemius equinus with a dedicated EGR system with retractable blade. J Foot Ankle Surg. 2012;51:714–9.PubMedCrossRefPubMedCentralGoogle Scholar
  140. 140.
    Yeap EJ, Shamsul SA, Chong KW, Sands AK. Simple two-portal technique for endoscopic gastrocnemius recession: clinical tip. Foot Ankle Int. 2011;32:830–3.PubMedCrossRefPubMedCentralGoogle Scholar
  141. 141.
    Thevendran G, Howe LB, Kaliyaperumal K, Fang C. Endoscopic gastrocnemius recession procedure using a single portal technique: a prospective study of fifty four consecutive patients. Int Orthop. 2015;39:1099–107.PubMedCrossRefPubMedCentralGoogle Scholar
  142. 142.
    Phisitkul P, Rungprai C, Femino JE, Arunakul M, Amendola A. Endoscopic gastrocnemius recession for the treatment of isolated gastrocnemius contracture: a prospective study on 320 consecutive patients. Foot Ankle Int. 2014;35:747–56.PubMedCrossRefPubMedCentralGoogle Scholar
  143. 143.
    Lui TH. Modified endoscopic release of gastrocnemius aponeurosis. J Foot Ankle Surg. 2015;54:140–2.PubMedCrossRefPubMedCentralGoogle Scholar
  144. 144.
    Lui TH, Mak CY. Cadaveric study of the junction point where the gastrocnemius aponeurosis joins the soleus aponeurosis. Open Orthop J. 2017;11(Suppl-4, M16):762–7. Scholar
  145. 145.
    Kangas J, Pajala A, Ohtonen P, Leppilahti J. Achilles tendon elongation after rupture repair: a randomized comparison of 2 postoperative regimens. Am J Sports Med. 2007;35(1):59–64. Scholar
  146. 146.
    Ellison P, Mason LW, Molloy A. Chronic Achilles tendon rupture reconstructed using hamstring tendon autograft. Foot. 2016;26:41–4. Scholar
  147. 147.
    Malagelada F, Clark C, Dega R. Management of chronic Achilles tendon ruptures—a review. Foot. 2016;28:54–60. Scholar
  148. 148.
    Chilvers M, Malicky ES, Anderson JG, Bohay DR, Manoli A II. Heel overload associated with heel cord insufficiency. Foot Ankle Int. 2007;28(6):687–9. Scholar
  149. 149.
    Kosanović M, Brilej D. Chronic rupture of Achilles tendon: is the percutaneous suture technique effective? Arch Orthop Trauma Surg. 2008;128(2):211–6. Scholar
  150. 150.
    Lui TH. A minimally invasive “overwrapping” technique for repairing neglected ruptures of the Achilles tendon. J Foot Ankle Surg. 2014;53(6):806–9. Scholar
  151. 151.
    Maffulli N, Spiezia F, Longo UG, Denaro V. Z-shortening of healed, elongated Achilles tendon rupture. Int Orthop. 2012;36(10):2087–93. Scholar
  152. 152.
    Bohnsack M, Ruhmann O, Kirsch L, Wirth CJ. Surgical shortening of the Achilles tendon for correction of elongation following healed conservatively treated Achilles tendon rupture. Z Orthop Ihre Grenzgeb. 2000;138(6):501–5. Scholar
  153. 153.
    Cannon LB, Hackney RG. Operative shortening of the elongated defunctioned tendoachillies following previous rupture. J R Nav Med Serv. 2003;89(3):139–41.PubMedPubMedCentralGoogle Scholar
  154. 154.
    Carmont MR, Maffulli N. Z shortening of healed Achilles tendon rupture: a technical note. Foot Ankle Int. 2009;30(7):704–7. Scholar
  155. 155.
    Yasuda T, Shima H, Mori K, Kizawa M, Neo M. Direct repair of chronic Achilles tendon ruptures using scar tissue located between the tendon stumps. J Bone Joint Surg Am. 2016;98(14):1168–75. Scholar
  156. 156.
    Yasuda T, Kinoshita M, Okuda R. Reconstruction of chronic achilles tendon rupture with the use of interposed tissue between the stumps. Am J Sports Med. 2007;35(4):582–8. Scholar
  157. 157.
    Lui TH. Endoscopic Achilles tendon shortening. Foot. 2017;35:5. Scholar
  158. 158.
    Ling SKK, Slocum A, Lui TH. 5-year results of the 1.5 cm incision Achilles tendon repair. Foot. 2017;33:35–8. Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Alastair Younger
    • 1
    • 2
  • Thomas S. Roukis
    • 3
  • Ho Lam Chai
    • 4
  • Tun Hing Lui
    • 4
    • 5
    • 6
    • 7
  • Mahmut Nedim Doral
    • 8
    • 9
  • Gazi Huri
    • 8
  • Naila Babayeva
    • 9
  • Egemen Turhan
    • 8
  • Gürhan Dönmez
    • 9
  • Charles Churk Hang Li
    • 4
  • E. Rabat
    • 10
  • J. Torrent
    • 11
  • M. Bernaus
    • 11
  • Wai Chung Chan
    • 12
  1. 1.Head Division of Distal Extremities, Department of OrthopaedicsUniversity of British ColumbiaVancouverCanada
  2. 2.St. Paul’s HospitalVancouverCanada
  3. 3.Orthopaedic CenterGundersen Health SystemLa CrosseUSA
  4. 4.Department of Orthopaedics and TraumatologyNorth District HospitalHong KongChina
  5. 5.Department of OrthopaedicsSouthern Medical UniversityGuangzhouChina
  6. 6.Institute of Biomedicine and Biotechnology, Shenzhen Institutes of Advanced Technology, Chinese Academy of ScienceShenzhenChina
  7. 7.Department of Orthopaedics and TraumatologyChinese University of Hong KongHong KongChina
  8. 8.Department of Orthopaedics and TraumatologyHacettepe UniversityAnkaraTurkey
  9. 9.Department of Sports MedicineHacettepe UniversityAnkaraTurkey
  10. 10.Foot and Ankle DepartmentHospital QuironBarcelonaSpain
  11. 11.Foot and Ankle DepartmentHospital Universitari Mutua de TerrassaBarcelonaSpain
  12. 12.Department of Orthopaedics and TraumatologyPamela Youde Nethersole Eastern HospitalHong KongChina

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