Achilles Rupture in the Setting Posterior Tibial Osteochondroma: A Case Report and Guidelines for Management of Osteochondromas Adjacent to Tendons

INTRODUCTION: The presentation of the included patient is unique, and the thought process regarding management algorithms used to manage this patient is important to discuss so that other surgeons may benefit. This is the first report of its kind, to our knowledge. CASE REPORT: A 30-year-old healthy Caucasian male presented with acute Achilles tendon rupture after feeling a pop while playing basketball, in the setting of a known posterior tibial osteochondroma and a recent increase in physical activity. CONCLUSION: The resultant injury is likely due to mechanical irritation at the tendon site, which caused wear over time and eventual acute rupture. We expanded our percutaneous repair to include an evaluation of the posterior compartment to adequately visualize and excise the large bony lesion. Therefore, we conclude that it is reasonable to counsel patients with known osteochondromas in this location due to the risk of possible Achilles injury, particularly if at all symptomatic.