2009年10月4日星期日

Achilles Tendonitis(3)



The Surgical Treatment of Achilles Tendonosis
Following the MRI or ultrasound scan the extent of degenerative change will have been defined. The two main types of operative intervention for Achilles tendonosis are either a stripping of the outer sheath (paratenon) and longitudinal incisions into the tendon or a major debridement of large portions of the tendon and then reconstruction of the remaining tendon using a flexor hallucis longus tendon transfer.
What Is The Rationale Behind The Operations for Achilles Tendonosis?
In cases of Achilles tendonosis with more minor degrees of degeneration such areas of tendon can be stimulated to repair themselves by incising the tendon, in the line of the fibres, which stimulates an ingrowth of blood vessels and results in the healing response. With severe Achilles tendonosis, if a large area of painful tendon needs to be excised then a large defect is left. This defect needs to be filled and this is best done by transferring the flexor hallucis longus muscle belly and tendon, which is adjacent to the Achilles tendon.

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