Many patients have pain at the insertion of their Achilles tendon, where it attaches to their heel bone (calcaneus). In this case, the patient had long standing pain with a prominent, palpable, bone spur on the back of the heel. Many times patients with this issue will not improve with physical therapy alone. The traditional surgery involves a large incision directly on the back of the heel in order to remove the bone. This unfortunately, is a high risk area of the body for healing and it is possible to have complications after surgery such as infection and wound healing issues. With an MIS approach, the incisions are much smaller and with less risk of infection. Despite not being able to directly visualize the bone, your surgeon can remove the bone with a bur and then perform an arthroscopy of the posterior ankle to evaluate and repair the tendon back to the bone. Due to the lack of major wound problems, many patients, who would otherwise be excluded due to high risk of wound healing issues may be candidates for this MIS procedure. Finally, patients are allowed to fully weight bear as tolerated in a boot the day after surgery.