Background: It is taught that ruptures of the Achilles tendon occur at the musculotendinous junction and indeed ultrasound reports will often confirm this. This study investigates the orthopaedic surgeon’s understanding of the clinical significance and location of the musculotendinous junction.

Materials and Methods: A survey of orthopaedic surgeons at a regional orthopaedic meeting. Two transverse lines were drawn on a photograph of a lower limb identifying the musculotendinous junction, and marking the highest level at which they would consider a surgical repair. They were asked about their understanding of the term “musculotendinous junction”.

Results: Twenty two delegates of various degrees of seniority responded.

Surgeons estimate of musculotendinous junction level: 10.1 cm

Conclusions: There is confusion regarding the exact location and nature of the Achilles musculotendinous junction amongst orthopaedic surgeons. Particular care is advised when interpreting ultrasound reports. An Achilles surgical zone has been identified (0–10 cm from the calcaneal insertion) within which the majority of surgeons would consider surgical intervention for rupture.