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Endoscopic Calcaneoplasty in Haglund Disease: Surgical Technique, Clinical and Subjective Outcomes
Guillermo Cardone1, Facundo Bilbao1, Jonathan M Verbner1
1Hospital Italiano de Buenos Aires, Foot and Ankle Section, Orthopaedics Department, Buenos Aires, Argentina.
Insights
Endoscopic calcaneoplasty effectively treats Haglund disease, significantly reducing pain and improving foot function. This minimally invasive surgery offers excellent outcomes with minimal complications for patients.
Area of Science:
- Orthopedic Surgery
- Minimally Invasive Procedures
Background:
- Haglund disease is increasingly treated with arthroscopic techniques due to their advantages over open surgery.
- Endoscopic calcaneoplasty allows for the resection of posterosuperior calcaneal exostosis and retrocalcaneal bursitis.
Purpose of the Study:
- To describe the endoscopic calcaneoplasty technique for Haglund disease.
- To report the clinical and subjective outcomes of this procedure.
Main Methods:
- A retrospective study of 14 patients undergoing endoscopic Haglund resection between July 2014 and March 2020.
- Patient outcomes were assessed using the Visual Analog Scale (VAS) for pain and the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scale.
Main Results:
- Endoscopic calcaneoplasty led to a significant improvement in VAS scores (9.07 to 1.8) and AOFAS scores (38.7 to 94.6).
- 85.7% of patients reported good subjective outcomes, with all willing to undergo the surgery again.
- No wound complications, infections, or reoperations were reported.
Conclusions:
- Endoscopic calcaneoplasty is a safe and effective treatment for Haglund disease.
- The procedure demonstrates favorable clinical and subjective results with a low complication rate.
Background:
During the last decade, arthroscopic procedures have been replacing open techniques in Haglund disease treatment because of their considerable advantages. Endoscopic calcaneoplasty is a technique that allows resection of posterosuperior calcaneal exostosis and retrocalcaneal bursitis. The objective of this article was to describe this technique and report its clinical and subjective outcome.
Methods:
A retrospective study was performed of consecutive patients undergoing endoscopic Haglund resection surgery between July 2014 and March 2020 at a single academic institution. All patients were surveyed in person about the level of pain (visual analog scale), its location (central, lateral, medial or diffuse), its relation with rest, or physical activity. Clinical evaluation was assessed using the hindfoot scale designed by the American Orthopaedic Foot & Ankle Society (AOFAS).
Results:
In this study, 14 endoscopic calcaneoplasties were performed in 14 patients, with an average follow-up of 40 months. The visual analog scale score improved from a preoperative average value of 9.07 to 1.8 after surgery (P > .0001). The AOFAS scale rose from 38.7 before surgery to 94.6 postoperative (P > .0001). Good subjective results were observed in 12 patients (85.7%), and all of them would have surgery again. There were no wound complications or infections. No patient required reoperation.
Conclusion:
In this relatively small cohort, we found that endoscopic calcaneoplasty was associated with good clinical and subjective results with few complications.
