Endoscopic release of Achilles peritenon.

Peritenonitis is the most common cause of achillodynia. When conservative treatment fails, surgical decompression of the Achilles tendon (AT) has achieved high rates of satisfactory results. The aim of this study was to evaluate an alternative endoscopic procedure in Achilles peritenon releasing. We performed endoscopy in nine cadaveric limbs. Three 1-cm portal approaches were performed on the skin overlying the AT area where a slotted cannula was placed subcutaneously. The crural fascia and the peritenon were cut longitudinally using a reverse knife while adhesions were freed. After endoscopy, open exposure failed to disclose any damage to the sural or calcaneal nerve. Endoscopically, the AT was seen throughout its course from the myotendinous junction excepting the distal 2 cm where the tendon is normally attached to the skin. Since the crural fascia and the Achilles peritenon are readily released by endoscopy in cadaveric specimens, findings support this procedure as a valid alternative to treat AT disorders such as peritenonitis.