Percutaneous Zadek Osteotomy for Insertional Achilles Tendinopathy.

Gonzalez, Tyler A; Kiriluk, Sarah Hall; Schipper, Oliver N · Foot Ankle Clin · 2026

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Abstract

The gold standard intervention for insertional Achilles tendinopathy with or without Haglund's deformity has been the open midline Achilles tendon splitting approach for many years. While this is a successful and highly vetted technique, this open hindfoot procedure has been associated with several complications and an extensive post-operative recovery. In comparison, the percutaneous Zadek osteotomy (ZO) has demonstrated safe and effective healing in patients with insertional Achilles tendinopathy with or without Haglund's deformity, with very minimal complications. Additionally, patients who undergo ZO experience a relatively early return to function and activity.

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