The Surgeons Perspective

I first met Nigel John in 2016 and diagnosed insertional Achilles tendinopathy

He had already worked hard with physiotherapy and we initially augmented this with shock wave therapy. The results initially were excellent but unfortunately his symptoms returned.

Occasionally with this type of problem injections are helpful if the predominant diagnosis is a retrocalcaneal bursa. We try to avoid injecting steroids around the tendon itself as they sometimes weaken the tendon enough to rupture.

If a Haglund deformity is the main issue, removing this extra piece of bone in an open or minimally invasive operation, can solve the problem.

Unfortunately for Nigel John he had a Haglund deformity, retrocalcaneal bursitis and insertional tendinopathy. Having exhausted all non-operative options we decided to proceed with surgery. This involves detaching the tendon from the bone, removing the Haglund deformity and bursa and then re-attaching the tendon. We used all sorts of high-tech tendon anchors as the forces that go through the tendon bone junction are many times body weight. Following surgery he was treated in a boot to protect the repair for 8 weeks. This is very similar to the boots used when the Achilles tendon ruptures spontaneously during sport.

He worked hard at the post-op rehabilitation and I am delighted to see that he is back in the lake district.

The Patient’s Perspective

After many years of an active life – rugby, windsurfing, skiing, hill walking and sea kayaking, an old injury to my Achilles tendon had got to the point where walking more than a few hundred yards became very painful. My physio recommended an appointment with Nick Savva to determine the cause of the problem and possible treatments. As an active sportsman himself, Nick immediately understood my goal of being able to get back to my fully active life and saw that as his objective for my treatment as well.

An initial course of shockwave therapy provided a brief respite from the pain, but after a couple of months the situation was back to square one. Nick determined that an operation to detach and repair my Achilles tendon and remove a bone spur from my ankle underneath the point of insertion of the Achilles was necessary. After clear explanations of the operation itself and the necessary rehabilitation programme following surgery, I had the operation done five months ago.

I am now already back on my bike, paddling my sea kayak and walking longer and longer distances off-road as each week goes by. I found Nick to be a very focussed consultant and someone who will only proceed with a course of treatment if he believes it will create a good outcome. I cannot recommend him highly enough.