Decompression with debridement has been shown to be effective in pain management in patients with chronic mid-portion Achilles tendinopathy; however, augmentation with the flexor hallucis longus tendon can provide additional mechanical support. The technique of endoscopic debridement of the tendinopathic tendon together with flexor hallucis longus transfer is described to treat patients suffering from chronic painful noninsertional Achilles tendinopathy with the potential advantage of minimally invasive surgery.
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