Procedure
Haglund Resection & Achilles Reconstruction
For Insertional Achilles Tendinopathy
What It Involves
This is the traditional open surgical approach to insertional Achilles tendinopathy and Haglund's deformity. The bony prominence at the back of the heel is excised, and the diseased, degenerate portion of the Achilles tendon at its insertion is debrided. Because this typically requires detaching the tendon from the heel bone to access the insertion fully, the tendon is then securely reattached using suture anchors.
The procedure is performed under general or regional anaesthesia. Because the tendon has been detached and reattached, protection of the repair is more extensive than for a Zadek osteotomy, with a correspondingly longer period in a protective boot.
Recovery Timeline
Everyone heals at a different rate — this timeline is a guide.
Weeks 1–2
An equinus cast holds the ankle in a slightly plantarflexed position to protect the tendon repair. The wound is checked and sutures removed at 2 weeks.
Weeks 2–10/12
Transition into a Vacoped boot, locked in plantarflexion to protect the reattached tendon — the longest period of protected boot wear of any Achilles procedure. The boot angle is gradually brought back toward neutral over this period as the repair heals.
3–4 months
Transition into supportive footwear, with physiotherapy for graduated Achilles loading and calf strengthening. Low-impact activity generally resumes by this stage.
5–6 months
Running and higher-impact activity are reintroduced gradually, guided by symptoms and physiotherapy progress, with a final review and discharge once activity has been comfortably resumed.