Calcific insertional Achilles tendinopathy: reattachment with bone anchors

Am J Sports Med. Jan-Feb 2004;32(1):174-82. doi: 10.1177/0363546503258923.


Background: Recalcitrant calcific insertional Achilles tendinopathy is difficult to treat.

Hypothesis: Bursectomy, excision of the distal paratenon, disinsertion of the tendon, removal of the calcific deposit, and reinsertion of the Achilles tendon with bone anchors is safe and effective.

Study design: Longitudinal study.

Methods: Twenty-one patients (six women) (21 feet) (average age 46.9 +/- 6.4 years) with recalcitrant calcific insertional Achilles tendinopathy were treated surgically with removal of the calcific deposit; the Achilles tendon was reinserted with bone anchors.

Results: At an average follow-up of 48.4 months, one patient necessitated a further operation. Eleven patients reported an excellent result, and five a good result. The remaining five patients could not return to their normal levels of sporting activity and kept fit by alternative means. The results of the VISA-A questionnaire were markedly improved in all patients, from an average of 62.4% to 88.1%.

Conclusions: We recommend disinsertion of the Achilles tendon to excise the calcific deposit fully and reinsertion of the Achilles tendon in the calcaneus with suture anchors. No patient experienced a traumatic disinsertion of the reattached tendon. However, five patients were not able to return to their original level of physical activity.

MeSH terms

  • Achilles Tendon / diagnostic imaging
  • Achilles Tendon / physiopathology
  • Achilles Tendon / surgery*
  • Adult
  • Calcinosis / diagnostic imaging
  • Calcinosis / physiopathology
  • Calcinosis / surgery*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Orthopedic Fixation Devices*
  • Radiography
  • Statistics, Nonparametric
  • Tendon Injuries / diagnostic imaging
  • Tendon Injuries / physiopathology
  • Tendon Injuries / surgery*