Haglund resection versus Haglund non-resection for calcific insertional Achilles tendinopathy with Haglund deformity:...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Musculoskeletal Disorders

Background:

• Calcific insertional Achilles tendinopathy (CIAT) with Haglund deformity is a challenging condition.
• The necessity of simultaneously removing the Haglund deformity during CIAT treatment remains debated.

Purpose of the Study:

• To compare functional outcomes of Haglund resection versus non-resection in treating CIAT with Haglund deformity.
• To evaluate the impact of Haglund deformity resection on patient recovery and anatomical changes.

Main Methods:

• Retrospective study of 29 patients undergoing Achilles tendon debridement, bursal excision, and reattachment.
• Patients were divided into Haglund resection (n=16) and non-resection (n=13) groups.
• Functional outcomes (AOFAS, VAS, VISA-A) and time to activities of daily living (ADL) were assessed. Radiographic measurements (Fowler-Philip angle, calcaneal pitch, tendon force arm) were analyzed.

Main Results:

• Both groups showed significant improvements in AOFAS, VAS, and VISA-A scores post-surgery.
• No significant differences were found between groups for AOFAS, VAS, or VISA-A scores.
• The non-resection group had a significantly faster mean time to ADL (8.15 weeks vs. 11.31 weeks).
• Radiographic analysis revealed significant changes in the resection group, including decreased Fowler-Philip angle and Achilles tendon force arm, and increased calcaneal pitch angle.

Conclusions:

• Both Haglund resection and non-resection provide satisfactory functional outcomes for CIAT with Haglund deformity.
• Haglund non-resection may accelerate patients' return to daily activities.
• Haglund deformity resection may not be essential for surgical treatment of CIAT with Haglund deformity.