When tendo achillis bursitis associated with prominence of the superior part of the tuberosity of the calcaneus does not respond to conservative measures, it may be necessary to excise the prominence. Thirteen patients with twenty symptomatic heels were treated surgically (seventeen excisions and three osteotomies). Good results were obtained in fifteen of the heels so treated. Five patients with retrocalcaneal bursitis in six heels were treated surgically. The initial result was good in all, but in two patients the final result was considered poor because of recurrence of pain as a manifestation of generalized rheumatoid arthritis.
Osteotomy to reduce the posterior prominence yielded results rated good in two and fair in one of the three heels with tendo achillis bursitis and results rated poor in two heels (one patient) with retrocalcaneal bursitis. The two poor results were not necessarily secondary to osteotomy. There were too few osteotomies in this series to evaluate the method. However, one disadvantage of osteotomy was the longer convalescence after this procedure.