by Carlos A. Uquillas, Michael S. Guss, Devon J. Ryan, Laith M

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Presentation transcript:

Everything Achilles: Knowledge Update and Current Concepts in Management by Carlos A. Uquillas, Michael S. Guss, Devon J. Ryan, Laith M. Jazrawi, and Eric J. Strauss J Bone Joint Surg Am Volume 97(14):1187-1195 July 15, 2015 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Gross anatomy of the Achilles tendon, showing innervation from the sural nerve and insertion on the posterior aspect of the calcaneus. Gross anatomy of the Achilles tendon, showing innervation from the sural nerve and insertion on the posterior aspect of the calcaneus. Carlos A. Uquillas et al. J Bone Joint Surg Am 2015;97:1187-1195 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Microscopic anatomy of the Achilles tendon. Microscopic anatomy of the Achilles tendon. The paratenon is a flexible connective tissue structure that surrounds the tendon itself. Carlos A. Uquillas et al. J Bone Joint Surg Am 2015;97:1187-1195 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Sagittal T2-weighted MRI cut demonstrating insertional Achilles tendinopathy with surrounding paratenonitis. Sagittal T2-weighted MRI cut demonstrating insertional Achilles tendinopathy with surrounding paratenonitis. There is no evidence of a tendon tear. There is a trace amount of fluid within the retrocalcaneal bursa and a small dorsal calcaneal enthesophyte is visible. Carlos A. Uquillas et al. J Bone Joint Surg Am 2015;97:1187-1195 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Ultrasound image demonstrating an Achilles tendon tear. Carlos A. Uquillas et al. J Bone Joint Surg Am 2015;97:1187-1195 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Treatment algorithm for management of the wide variety of Achilles tendon pathology encountered by the orthopaedic surgeon. Treatment algorithm for management of the wide variety of Achilles tendon pathology encountered by the orthopaedic surgeon. XR = x-rays, US = ultrasound, and FHL = flexor hallucis longus. Carlos A. Uquillas et al. J Bone Joint Surg Am 2015;97:1187-1195 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Preoperative photograph showing a planned medial incision and direct repair. Carlos A. Uquillas et al. J Bone Joint Surg Am 2015;97:1187-1195 ©2015 by The Journal of Bone and Joint Surgery, Inc.