Lateral approach for insertional Achilles tendinitis with Haglund deformity.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Foot and Ankle Surgery

Background:

• Insertional Achilles tendinitis (IAT) with Haglund deformity often requires surgical intervention when conservative treatments fail.
• The Haglund deformity, a bony enlargement on the heel bone, can exacerbate IAT by causing impingement.
• Surgical options aim to address both the tendinitis and the bony abnormality.

Purpose of the Study:

• To evaluate the functional outcomes of a lateral surgical approach for patients with IAT and Haglund deformity.
• To assess the safety and efficacy of this surgical technique in improving patient-reported scores.

Main Methods:

• A retrospective study of 14 patients with IAT and Haglund deformity who underwent surgery between January 2016 and September 2019.
• A lateral approach was utilized for debridement of bone and soft tissue, followed by Achilles tendon reattachment.
• Clinical outcomes were assessed using the Visual Analog Scale (VAS), American Orthopedic Foot and Ankle Score (AOFAS), and the Victorian Institute of Sport Tendon Study Group-Achilles Tendinopathy score (VISA-A).

Main Results:

• The mean follow-up period was 14.74 months.
• Significant improvements were observed in VAS scores (decreased from 4.86 to 1.21, P < 0.001) and AOFAS scores (improved from 66.64 to 90.21, P < 0.001).
• The VISA-A score also showed significant improvement, increasing from a mean of 66 preoperatively to 86 postoperatively (P < 0.05).

Conclusions:

• The lateral approach is a safe and effective surgical option for managing insertional Achilles tendinitis with Haglund deformity.
• This surgical technique demonstrates promising mid-term functional outcomes for affected patients.