Endoscopic Haglund's Resection and Percutaneous Double-Row Insertional Achilles Repair

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Minimally Invasive Procedures

Background:

• Insertional Achilles tendinopathy often resists conservative treatments like bracing and physical therapy.
• Traditional open surgery involves debridement and spur resection, with suture anchors for repair.
• Advances include double-row repairs for better biomechanics and minimally invasive/endoscopic techniques to reduce complications.

Purpose of the Study:

• To present a novel minimally invasive surgical technique for treating insertional Achilles tendinopathy and calcaneal bone spurs.
• To incorporate endoscopic visualization and a percutaneous double-row suture anchor repair.

Main Methods:

• A technique using 4 portals for 2 endoscopic working planes was employed.
• Calcaneoplasty was performed using a burr deep to the tendon.
• Endoscopic debridement of diseased tendon and bony spurs was followed by a double-row suture anchor repair.

Main Results:

• The described technique allows for minimally invasive treatment of insertional Achilles tendinopathy and calcaneal spurs.
• The use of endoscopic visualization and percutaneous double-row suture anchor repair facilitates efficient debridement and secure fixation.
• This approach aims to minimize wound complications and infection while enabling faster rehabilitation.

Conclusions:

• Minimally invasive surgery combined with endoscopic techniques and double-row suture anchor repair offers a viable treatment option for insertional Achilles tendinopathy.
• This technique addresses both the tendinopathy and associated calcaneal bone spurs effectively.
• Further studies may be needed to establish long-term outcomes and compare with traditional methods.