Central Tendon-Splitting Approach and Double Row Suturing for the Treatment of Insertional Achilles Tendinopathy
Figure 5
Case 2, 24-year-old male complained of right posterior heel pain for 2 years with blood uric acid of 692 mmol/L. (a) Preoperative radiograph showed calcification of calcaneus in the Achilles tendon insertion. (b) Preoperative MRI found edematous and thickened Achilles tendon, posterior calcanues bursitis and edema in the posterosuperior calcaneus. (c) Postoperative radiograph showed calcaneal calcification had been removed and anchor position was satisfying. (d) Central tendon-splitting approach was used to perform the surgery. (e) After splitting the Achilles tendon, the denaturation tendon could be visualized. (f) The removed denatured paratendon tissue. (g)-(h) The lesion tissue was stained by haematoxylin and eosin. Under the light microscope (100× and 200×), infiltrating neutrophils, lymphocytes were found, and the white arrow showed multinucleated giant cells in different morphologies and sizes surrounding the urate crystal.