What is: Achilles ‘Scraping’ for Tendinopathy

What is it?

The Achilles tendon scraping surgical procedure is a successful treatment for chronic painful midportion Achilles Tendinopathy. 

It is a mini-invasive procedure performed under local anesthetic through a 1 cm long skin incision.  The deep side of the Achilles is visualized and the infiltrative fat, blood vessels and nerves are scraped away from the deep side of the Achilles tendon. Scraping is guided by findings on ultrasound and colour-doppler.  

As treatment is performed outside the tendon, this allows for immediate weight-bearing and progressive increase in loading. Most patients can return to running in 6-8 weeks. 

Related articles:

  • Alfredson H. Editorial. Where to now with Achilles tendon treatment? Br J Sports Med 2011; 45:386. 
  • Alfredson H. Ultrasound and Doppler-guided mini-surgery to treat midportion Achilles tendinosis: results of a large material and a randomised study comparing two scraping techniques Br J Sports Med 2011;45 407-410.
  • Ruergård A, Alfredson H. Major physical but also psychological effects after pain relief from surgical scraping in patients with Achilles tendinopathy-a 1-year follow-up study. PST  Vol.2 No.1: 21-25. 2014.
  • Masci L, Spang C, van Schie H TM, Alfredson H. Achilles tendinopathy-do plantaris tendon removal and Achilles scraping improve tendon structure? A prospective study using ultrasound tissue characterisation. BMJ Open Sport Exerc Med 2015;1:e000005doi:10.1136/bmjsem-2015-00000
  • Alfredson H. Low recurrence rate after mini surgery outside the tendon combined with short rehabilitation in patients with midportion Achilles tendinopathy. Open J Sports Med 2016;7 :51-54.