Walking pain-free: A prospective study on the efficacy of surgical resection with Achilles tendon reinforcement for painful Haglund lesions

Abstract

Background Haglund’s deformity is a common cause of posterior heel pain, often requiring surgical management when conservative treatment fails. Traditionally, surgery focused solely on resection of the bony prominence, yielding suboptimal outcomes. Aim This study assessed the efficacy of surgical resection of painful Haglund lesions combined with Achilles tendon reinforcement for managing insertional Achilles tendinitis. Methods Twenty patients with insertional Achilles tendinitis underwent surgical resection of Haglund lesions and Achilles tendon reinforcement with suture anchors. Functional outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score preoperatively and at 6 and 12 months postoperatively. Complications were recorded. Results The mean AOFAS score significantly improved from 43.5 ± 7.2 preoperatively to 79.0 ± 9.1 at 6 months and 84.5 ± 9.8 at 12 months postoperatively (P<0.001). Early weight-bearing was achieved in 2 weeks. The complication rate was 25% (all minor). There were no re-ruptures or revisions during the one-year follow-up. Conclusion Surgical resection combined with Achilles tendon reinforcement is an effective treatment for Haglund’s deformity, allowing early weight-bearing while significantly improving function. It is associated with a low complication rate and no major adverse events. This technique addresses both bony and soft tissue pathologies, optimizing outcomes.