Outcome of Endoscopic Calcaneoplasty in Insertional Achilles Tendinopathy with Retrocalcaneal Bursitis. A New Prospective Study

Achilles tendinopathy is a common hind foot disorder which affects both the active and non-active population. It’s occurence among Asians has shown an increasing trend due to their active involvement in sporting activities but limited literature is available documenting on Achilles tendinopathy. It can be classified as insertional and noninsertional tendinopathy [1]. Insertinal tendinopathy is responsible for 20% to 25% of total Achilles tendon related disorders [2] and usually associated with retrocalcaneal bursitis. Insertional Achilles tendinopathy is a clinical syndrome consisting of pain, swelling and impaired performance. The pathology is located at the insertion of Achilles tendon on the postero-superior part of calcaneum and commonly associated with formation of bone spurs and calcifications of Achilles tendon. Insertional Achilles tendinopathy is purely a clinical diagnosis. Patients presents with complaint of pain, appear at the beginning and ending of walking session, stiffness and occasionally swelling of the hind foot. Examination findings include visible swelling, tenderness at postero-lateral aspect of the calcaneum and a palpable bony spur. Imaging like plain radiography and MRI can be used to support the diagnosis and exclude the differential diagnosis. Plain radiography may show ossification, a bone spur at the tendon’s insertion or radioopacity of the retrocalcaneal recess. Meanwhile, MRI may reveal any bone formation or hyper intense signal at tendon insertion or retrocalcaneal recess.