For patients with tendonopathy but no deformity a simple debridement may be considered.
Two small series have been reported. 90% had good pain relief and 90% had normal single foot tiptoe tests.
This procedure may be satisfactory for a small number of patients. However, many patients have a pre-existing flatfoot and there is a strong case for improving the biomechanical environment of the debrided tendon with a posterior medial displacement calcaneal osteotomy. In addition, Conti et al (1992) showed that surgical inspection tends to underestimate tendonopathy and therefore early good results may not last. 10% of patients in the reported series developed progressive deformity and underwent further surgery.