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Endoscopic calcaneoplasty (ECP) as a surgical treatment of Haglund's syndrome
Joerg Jerosch1, J Schunck, S H Sokkar
1Department for Orthopedic Surgery, Johanna-Etienne-Hospital, Am Hasenberg 46, 41462 Neuss, Germany. j.jerosch@jek-neuss.de
Insights
Endoscopic calcaneoplasty (ECP) offers an effective, minimally invasive treatment for posterior calcaneal exostosis. This technique shows superior outcomes and fewer complications compared to traditional open surgery.
Area of Science:
- Orthopedic Surgery
- Minimally Invasive Procedures
Background:
- Posterior calcaneal exostosis treatment remains controversial.
- Open surgical resection often yields unsatisfactory results and complications.
- Endoscopic calcaneoplasty (ECP) presents a potential alternative.
Purpose of the Study:
- To evaluate the efficacy and safety of endoscopic calcaneoplasty (ECP) for posterior calcaneal exostosis.
- To compare ECP outcomes with traditional surgical methods.
Main Methods:
- 81 patients (25-55 years) with posterior superior calcaneal exostosis underwent ECP.
- All patients had failed conservative treatment for at least 6 months.
- Radiographic and clinical assessments were performed, with an average follow-up of 35.3 months.
Main Results:
- Excellent or good results were achieved in 82 out of 81 patients (98.7%) based on the Ogilvie-Harris-Score.
- Postoperative radiographs confirmed sufficient spur resection.
- Only minor postoperative complications were observed.
Conclusions:
- Endoscopic calcaneoplasty (ECP) is an effective minimally invasive procedure for treating calcaneal exostosis.
- ECP demonstrates advantages over open techniques, including reduced morbidity, shorter operating time, and minimal complications.
- The endoscopic approach allows for better differentiation of pathology.
Abstract:
Posterior calcaneal exostosis treatment modalities showed many controversial opinions. After failure of the conservative treatment, surgical bursectomy and resection of the calcaneal exostosis are indicated by many authors. But clinical studies also show a high rate of unsatisfactory results with a relative high incidence of complications. The minimal surgical invasive technique by an endoscopic calcaneoplasty (ECP) could be an option to overcome some of these problems. We operated on 81 patients with an age range between 25 and 55 years, 40 males and 41 females. The radiologic examination prior to surgery documented in all cases a posterior superior calcaneal exostosis that showed friction to the Achilles tendon. All patients included in the study had neither clinical varus of the hind foot nor cavus deformities. All patients had undergone a trial of conservative treatment for at least 6 months and did not show a positive response. The average follow-up was 35.3 months (12-72). According to the Ogilvie-Harris-Score, 34 patients presented good and 41 patients excellent results, while three patients showed fair results, and three patients only poor results. All the post-operative radiographs showed sufficient resection of the calcaneal spur. Only minor postoperative complications were observed. ECP is an effective and of minimal-invasive procedure for the treatment of patients with calcaneal exostosis. After a short learning curve, the endoscopic exposure is superior to the open technique has less morbidity, less operating time, and nearly no complications; moreover, the pathology can better be differentiated.
