Operative Treatment of Haglund Syndrome With Central Achilles Tendon-Splitting Approach

Ahn, Jae Hoon; Ahn, Chiyoung; Byun, Chu-Hwan; Kim, Yoon-Chung

doi:10.1053/j.jfas.2015.05.002

Cited by 54 publications

(66 citation statements)

References 28 publications

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“…(9,14,19,27) Similarly, significant improvements in pain and function were noted in the CA group, and the results were in agreement with observations reported by previous studies. (20,25,28,29) The two approaches were comparable in effectiveness in improving pain scores, AOFAS Ankle-Hindfoot Scales and SF-36 scores, and this is consistent with the findings of Anderson et al (30) In our study, the satisfaction rate of surgery using the CA was 87.5%, which falls within the range of 77%-100% reported in the literature. (15,28,29,31) The satisfaction rate with the LA was 87.2% with no significant difference between the two approaches in terms of subjective evaluation.…”

Section: Discussionsupporting

confidence: 91%

Lateral versus central tendon-splitting approach to insertional Achilles tendinopathy: a retrospective study

Xia¹,

Yew²,

Zhang³

et al. 2019

smedj

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This study aimed to compare operative outcomes between the lateral approach (LA) and the central approach (CA) to insertional Achilles tendinopathy (IAT). METHODS We retrospectively reviewed patients who underwent surgical treatment for IAT using the LA or CA. Patients' demographic data, postoperative complications and satisfaction rate were reviewed. Clinical outcomes were prospectively assessed preoperatively, at three months postoperatively and at the last visit, including patients' visual analogue scale (VAS) scores for pain, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale scores and 36-item Short Form Health Survey (SF-36) scores. RESULTS There were 39 patients in the LA group and 32 in the CA group. In each group, average VAS and AOFAS Scale scores improved significantly. SF-36 scores improved in most parameters. No significant difference in baseline score; average AOFAS Scale score at each visit; and mean VAS score preoperatively and at last visit; satisfaction rate; and overall complication rate were observed between the groups. The mean VAS score in the LA group at postoperative three months was significantly lower than that in the CA group (2.7 ± 2.5 vs. 4.4 ± 3.0; p = 0.016). There were significantly more cases of delayed wound healing in the LA group than in the CA group (2.6% vs. 15.6%; p = 0.049). CONCLUSION Both approaches had comparable outcomes for IAT in terms of functional improvement, pain relief, overall enhancement of patients' health condition and overall postoperative complication rate. The LA provided better short-term pain relief and reduced delayed wound healing compared with the CA.

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Section: Discussionsupporting

confidence: 91%

Lateral versus central tendon-splitting approach to insertional Achilles tendinopathy: a retrospective study

Xia¹,

Yew²,

Zhang³

et al. 2019

smedj

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“…Despite only having short-term follow-up data at 6 or 12 weeks, the 70% rate of patient satisfaction with percutaneous ultrasonic tenotomy for IAT in this series was similar to the rates in other studies of tendinopathy at the elbow, which reported ranges from 75% to 100%. 2,4,7 In comparison, the satisfaction rate for surgical debridement of IAT is generally greater than 87%, [10][11][12][13][14][15][16][17][18] yet this high patient satisfaction rate also had complication rates ranging from 6% to greater than 30%, which included wound-healing issues (superficial would infection, skin necrosis, hematoma, and delayed wound healing), scar abnormalities (hypersensitivity, hypertrophy, and numbness), sural nerve injury, tendon avulsion, deep venous thrombosis, and recurrence of pain. 10,11,[13][14][15][16] There are several advantages of percutaneous ultrasonic tenotomy relative to an open or endoscopic surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Ultrasonic Tenotomy Reduces Insertional Achilles Tendinopathy Pain With High Patient Satisfaction and a Low Complication Rate

Chimenti

Stover

Fick

et al. 2018

J of Ultrasound Medicine

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Due to the novelty of percutaneous ultrasonic tenotomy, the risks and benefits of this minimally invasive procedure for insertional Achilles tendinopathy pain have only been examined in case studies and retrospective chart reviews for other diagnoses. This retrospective chart review over a 3.5‐year period identified 34 patients with insertional Achilles tendinopathy who had percutaneous ultrasonic tenotomy (mean age ± SD, 52.2 ± 11.6 years; mean body mass index, 32.9 ± 7.5 kg/m2; 62% female). This procedure reduced the rate of moderate/severe pain from 68% at baseline to 15% at the long‐term follow‐up and had a satisfaction rate of 70%. There was 1 minor complication out of 40 procedures in 34 patients.

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“…Results of the functional evaluations performed preoperatively and postoperatively (at 3 months, 6 months, 1 year, and the latest follow-up) were included to determine the AOFAS score [12] and VISA-A score [13]. Anatomy changes included changes in the Fowler-Philip angle [14], Bohler's angle [15], and calcaneal pitch angle [5] (Figure 3). To avoid examiner bias, the clinical evaluation and data analysis were performed by two independent physicians who were blinded to the study.…”

Section: Clinical and Radiographic Evaluationsmentioning

confidence: 99%

“…It is generally associated with insertional Achilles tendinopathy (IAT) and retrocalcaneal bursitis, which comprise the Haglund triad or Haglund syndrome [2,3]. Surgical intervention is a suitable option when conservative treatment for more than 4 (PPR), retrocalcaneal decompression, and endoscopic treatment, generally have good short-term clinical outcomes [5,6]. However, a few patients still experience some degree of pain after surgery, especially after PPR [7]; therefore, another surgical method is required for better outcomes.…”

Section: Introductionmentioning

confidence: 99%

Comparison of dorsal closing wedge calcaneal osteotomy versus posterosuperior prominence resection for the treatment of Haglund syndrome

Hong

et al. 2020

Preprint

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Background: Haglund syndrome is a common disease that causes posterior heel pain. This study compared the clinical outcomes of dorsal closing wedge calcaneal osteotomy (DCWCO) and posterosuperior prominence resection (PPR) for the treatment of Haglund syndrome.Methods: This retrospective study included 12 patients who underwent DCWCO and 32 patients who underwent PPR from January 2010 to August 2016. Patients were evaluated using the American Orthopedic Foot Ankle Society ankle-hindfoot scale (AOFAS), Victorian Institute of Sport Assessment Scale for Achilles tendinopathy (VISA-A), Fowler-Philip angle, Bohler's angle, and calcaneal pitch angle preoperatively and postoperatively (at 3 months, 6 months, 1 year, and the latest follow-up).Results: Both groups exhibited a significant increase in their AOFAS and VISA-A scores after surgery.The DCWCO group had lower AOFAS scores than the PPR group at 6 months (77.6 ± 5.1 vs. 82.8 ± 7.8; P =0.037) but had higher scores at the latest follow-up (98.2 ± 2.3 vs. 93.4 ± 6.1; P =0.030). The DCWCO group had lower VISA-A scores at 3 months (56.9 ± 13.9 vs. 65.2 ± 11.0; P =0.044) but higher scores at the latest follow-up (98.2 ± 2.6 vs. 94.3 ± 5.0; P =0.010) than the PPR group. Both groups exhibited significant changes in the Fowler-Philip angle and Bohler's angle after surgery. The postoperative Fowler-Philip angle of the DCWCO group was greater than that of the PPR group (35.9°± 4.9° vs. 31.4° ± 6.2°; P =0.026). However, there was no statistically significant difference in any other angle of the two groups postoperatively.Conclusions: Compare to PPR group, the DCWCO group had poorer short-term clinical outcomes but provide better long-term function and symptom remission. This method can be a good option for those patients with higher functional expectations. BackgroundHaglund deformity, first described by Patrick Haglund in 1928, is a prominence in the posterolateral heel that causes posterior heel pain [1]. It is generally associated with insertional Achilles tendinopathy (IAT) and retrocalcaneal bursitis, which comprise the Haglund triad or Haglund syndrome [2,3]. Surgical intervention is a suitable option when conservative treatment for more than 6 months has failed [4]. Common surgical methods, including posterosuperior prominence resection 4 (PPR), retrocalcaneal decompression, and endoscopic treatment, generally have good short-term clinical outcomes [5,6]. However, a few patients still experience some degree of pain after surgery, especially after PPR [7]; therefore, another surgical method is required for better outcomes.Dorsal closing wedge calcaneal osteotomy (DCWCO) was first described by Zadek for the treatment of IAT [8]. Keck and Kelly proved that DCWCO was an effective treatment for Haglund deformity in 18 patients [9]. Further, Miller reported that wedge osteotomy of the calcaneus body combined with resection of the superior calcaneus showed good results in 16 patients (18 feet) [10]. Dimitrios treated IAT with dorsal wedge calcaneal osteotomy in 52 athletes, al...

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Operative Treatment of Haglund Syndrome With Central Achilles Tendon-Splitting Approach

Cited by 54 publications

References 28 publications

Lateral versus central tendon-splitting approach to insertional Achilles tendinopathy: a retrospective study

Lateral versus central tendon-splitting approach to insertional Achilles tendinopathy: a retrospective study

Percutaneous Ultrasonic Tenotomy Reduces Insertional Achilles Tendinopathy Pain With High Patient Satisfaction and a Low Complication Rate

Comparison of dorsal closing wedge calcaneal osteotomy versus posterosuperior prominence resection for the treatment of Haglund syndrome

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