A Randomized Trial to Evaluate the Effectiveness of Transferring the Flexor Hallucis Longus Tendon

Insertional Achilles Tendinopathy: A Randomized Trial to Evaluate the Effectiveness of Transferring the Flexor Hallucis Longus Tendon

The optimal surgical treatment for insertional Achilles tendinopathy remains unclear. The purpose of this study is to evaluate the long-term outcome of surgical treatment by comparing the patient reported outcomes of Insertional Achilles Tendinopathy; Achilles tendon debridement, excision calcaneal exostosis, Strayer procedure, secondary repair of Achilles with flexor hallucis longus (FHL) transfer and Achilles tendon debridement, excision calcaneal exostosis, Strayer procedure, secondary repair of Achilles without FHL transfer.

Inclusion Criteria:

• Male and female 18 years or older

• Diagnosed with insertional Achilles tendinosis by history and physical exam

• Confirmed by x-ray and MRI

• Calcification at the Achilles insertion and gastrocnemius tightness.

• Failure of the following non-operative treatment for greater than 6 months: *shoe modifications

  • physical therapy
  • immobilization
  • and home exercise program.

• In addition, participant must have an intact flexor hallucis longus tendon.

Exclusion Criteria:

• Patients who have failed surgery for the same and patients with diabetic neuropathy.