Achilles Tendinitis

(Part 7)

Gastrocnemius Recession

This is a surgical lengthening of the calf (gastrocnemius) muscles. Because tight calf muscles place increased stress on the Achilles tendon, this procedure is useful for patients who still have difficulty flexing their feet, despite consistent stretching.

Contributed and/or Updated by

In gastrocnemius recession, one of the two muscles that make up the calf is lengthened to increase the motion of the ankle. The procedure can be performed with a traditional, open incision or with a smaller incision and an endoscope — an instrument that contains a small camera. Your doctor will

discuss the procedure that best meets your needs. Complication rates for gastrocnemius recession are low but can include nerve damage.

Minimally Invasive Surgery

Minimally invasive surgery has been increasing in popularity for treatment of many musculoskeletal conditions. For Achilles tendinitis, it may involve using small incision to place a camera and small instruments through the skin to remove damaged and inflamed Achilles tendon tissue.

Other minimally invasive surgeries include using small holes to release parts of the tendon and muscle from the bone. These techniques may become more popular with time, but there is still limited information on their effectiveness. Additionally, they may be less effective in patients with extensive tendon damage.

Outcomes

Results of Achilles tendinitis surgery are generally very good. Studies on tendon debridement have reported return to pre-surgical activity level in up to 75% of patients, with up to a 90% patient satisfaction rate. Gastrocnemius recession has also shown good results, with high rates of reduced pain and improved function after surgery.

The main factor in surgical recovery is the amount of damage to the tendon. The greater the amount of tendon involved, the longer the recovery period, and the less likely a patient will be able to return to sports activity.

Physical therapy is an important part of recovery. Many patients require up to 12 months of rehabilitation to reach maximum improvement.

Continued pain after surgery may be noted in up to 20% to 30% of patients and is the most common complication. In addition, wound infections can occur and may be difficult to treat in this location on the body.