Insertional Achilles tendinosis is a progressive condition that occurs where the Achilles tendon attaches to the heel bone.
The main goal of the surgery is to remove the damaged portion of the Achilles tendon and maintain tendon attachment to the heel bone. In cases where the damage is more involved, the entire Achilles tendon may need to be removed from the heel bone and the remaining good tendon reattached.

Sometimes a small amount of tendon can be removed, leaving the remaining Achilles tendon attached to the heel bone.
The tendon is reattached by using special bone anchors that allow the tendon to be fixed to the bone (see figures 2-4). If the tendon was not fully detached from the heel, the doctor may allow you walk around in the boot for six to eight weeks and work on motion exercises with physical therapy.

In this situation another tendon may need to be used to bridge the gap between the good Achilles tendon and the heel bone.

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