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The Journal of Bone and Joint Surgery 80:1814-24 (1998)
© 1998 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Disorders of the Insertion of the Achilles Tendon and Achilles Tendinitis*{dagger}

MARK S. MYERSON, M.D.{ddagger}, BALTIMORE, MARYLAND and WILLIAM McGARVEY, M.D.§, HOUSTON, TEXAS

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons


   Introduction
 
Because of its size and unique functional anatomy, the Achilles tendon is susceptible to both acute and chronic injury. This paper addresses some of these injuries, including the various forms of tendinitis as well as the various pain syndromes of the retrocalcaneal space, such as retrocalcaneal bursitis and Haglund deformity.


   Functional and Gross Anatomy
 
The Achilles tendon is the continuation of the triceps surae, which originates from the medial and lateral femoral condyles as the two heads of the gastrocnemius and continues as the gastrocnemius blends with the soleus distally. The Achilles tendon inserts onto the middle third of the posterior tuberosity of the calcaneus. At the bone-tendon junction, the enthesis is composed of calcified and noncalcified cartilage. Paratenon surrounds the tendon and is able to stretch two to three centimeters with movement of the tendon, thereby allowing the Achilles tendon to glide smoothly. The tendon is vascularized by anterior muscular branches as well . . . [Full Text of this Article]


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