Achilles Tendinopathy

Chronic Achilles tendinopathy involves a spectrum of symptoms consisting of pain, swelling and impaired function at the level of the Achilles tendon. This condition can be classified according to its anatomical location in insertional tendinopathy and mid-portion tendinopathy. This is usually secondary to a multifactorial process. The condition can be due to intrinsic or extrinsic factors. A complete clinical and imaging examination is mandatory to determine the appropriate final treatment for each patient. The treatment will depend on the involved tendon portion and the time of evolution. This requires management in stages, with conservative treatment being generally recommended as the initial strategy by modifying the extrinsic factors that cause it. Once this stage fails, surgical alternatives can be considered. The surgical technique must be selected for each patient based on the patient’s demand and the degree of tendon injury. Surgical interventions go from minimally invasive options such as arthroscopic debridement to open techniques with tendon repair or subtotal detachment.