Reconstruction of concurrent chronic insertional Achilles tendinosis and chronic midsubstance Achilles tendinosis with Haglund deformity: A case report

Abstract

Achilles tendinopathy affects athletes at all levels. While tendinopathy is usually found in either the midsubstance or the Achilles insertion, it is rarely seen in both areas of the tendon concomitantly. We report on a rare case of bilateral chronic insertional Achilles tendinosis and chronic midsubstance Achilles tendinosis with Haglund deformity treated with central tendon debridement, flexor hallucis longus (FHL) transfer, Haglund resection, and reattachment of the Achilles insertion using the Arthrex Speedbridge® system. To our knowledge, this case report is the first for the treatment of combined midsubstance and insertional Achilles tendinosis. Our method allows us to reapproximate the Achilles to its normal anatomy while eliminating the need for bulky suture knots and simultaneously giving an excellent clinical result.