Related Experiment Video
Updated: May 14, 2025
Author Spotlight: Recent Advancements in Reoperative Foregut Surgery
Published on: September 22, 2023
Patient characteristics, postoperative protocols, and surgical outcomes in Haglund's resection: a single-institution
Katherine M Kutzer1, Kali J Morrissette2, Kevin A Wu2
1Duke Medical Center, Durham, USA. katherine.kutzer@duke.edu.
Insights
This study analyzed Haglund's syndrome surgery in 390 patients, finding common demographics like older age and female sex. Outcomes were similar across repair types, with a low 1.8% revision rate.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
- Musculoskeletal Conditions
Background:
- Haglund's syndrome involves heel bone spurs, retrocalcaneal bursitis, and Achilles tendinopathy.
- Understanding patient demographics and surgical outcomes is crucial for effective management.
Purpose of the Study:
- To analyze patient demographics for Haglund's syndrome.
- To evaluate surgical techniques and perioperative decisions.
- To identify complications associated with Haglund's resection.
Main Methods:
- Retrospective cohort study of 390 patients undergoing Haglund's syndrome surgery.
- Data collected from January 2015 to July 2023.
- Analysis included demographics, surgical repair types, weightbearing status, and complications.
Main Results:
- The cohort averaged 55.14 years, with 66.4% females. Common demographics included obesity (BMI 34.83) and 17.4% diabetes.
- Complications occurred in 20.0% of patients, with persistent pain (10.3%) and wound breakdown (8.2%) being most frequent.
- A low revision rate of 1.8% was observed across different repair types and weightbearing protocols.
Conclusions:
- This study represents the largest single-institution series on operative Haglund's syndrome management.
- Prevalent patient characteristics align with existing literature, highlighting older age, female sex, obesity, and diabetes.
- Various surgical repair types and weightbearing strategies showed comparable outcomes, emphasizing a low reoperation rate.
Background:
Haglund's syndrome represents a triad of posterosuperior calcaneal bony enlargement, retrocalcaneal bursitis, and Achilles tendinopathy. This study aims to improve the understanding of patient demographics, inform surgical and perioperative decision-making, and identify complications surrounding Haglund's resection.
Methods:
Data were collected retrospectively from patients who received surgical treatment for Haglund's syndrome across 6 surgeons at an academic institution from January 2015 to July 2023. Demographic and surgical technique data were collected. Additional data included weightbearing status, complications, revisions, and date of patients' last follow-up. Descriptive statistics were completed.
Results:
Across 390 patients, the cohort averaged 55.14 years old and was 66.4% female. Most common racial groups included Caucasian (72.8%), African American (20.8%), and Asian (1.3%). The average Body Mass Index was 34.83 with range [21.1-53.4], and 17.4% had diabetes. Additionally, 68.5% of patients reported never smoking while 30% formerly or actively smoked. Repair type was divided among SpeedBridge (57.9%), titanium knotted suture anchor (21.3%), and knotless suture anchor (20.8%). Time to last follow-up had a median of 5.8 months, with range [0 days-7 years]. Postoperative recommendations included non weightbearing (68.7%), touchdown weightbearing (14.4%), weightbearing as tolerated (13.8%), and partial weightbearing (3.1%). Overall, 78 (20.0%) patients experienced a complication, including 40 (10.3%) persistent pain, 32 (8.2%) wound breakdowns, 7 (1.8%) infection, 6 (1.5%) plantar flexion weakness, 4 (1.0%) other, and 1 (0.3%) rupture, with 7 (1.8%) requiring revision.
Conclusion:
This retrospective study offers the largest single institution series for the operative management of Haglund's syndrome to date with long-term follow-up. Certain patient characteristics (older age, female sex, Black or African American race, obesity, and diabetes) were prevalent in this cohort, which reflects demographics previously reported in the literature. The different repair types and weightbearing recommendations demonstrated similar trends in outcomes, with a low reoperation rate of 1.8%.
Level Of Evidence:
Level III, Retrospective Cohort Study.
