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A Modified Heterotopic Swine Hind Limb Transplant Model for Translational Vascularized Composite Allotransplantation VCA Research

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Haglund Excision and Suture Bridge Repair.

Albert T Anastasio¹, Zoe Hinton¹, Richard Danilkowicz¹

¹Division of Sports Medicine, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA.

Video Journal of Sports Medicine

|May 1, 2025

Summary

This summary is machine-generated.

Surgical repair using an Achilles suture bridge technique offers a viable solution for Haglund deformity and insertional Achilles tendinopathy when conservative treatments fail. This method demonstrates promising outcomes with high patient satisfaction and minimal complications.

Keywords:

Achilles tendinopathy Haglund deformity conservative management indications speed bridge repair

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Area of Science:

Orthopedic Surgery
Foot and Ankle Surgery

Background:

Haglund deformity and insertional Achilles tendinopathy are characterized by disorganized collagen and mucoid degeneration, leading to pain and swelling.
These conditions result from a degenerative process affecting the Achilles tendon and heel bone.

Purpose of the Study:

To explore operative management for Haglund deformity and insertional Achilles tendinopathy refractory to nonoperative treatments.
To evaluate the efficacy and outcomes of a distally based midline incision technique with an Achilles suture bridge repair.

Main Methods:

A distally based midline incision is used to access and excise degenerative tissue and the Haglund deformity.
An Achilles suture bridge technique with dual-row suture anchors and a modified Mason-Allen technique is employed for tendon repair.
Postoperative management includes early weight-bearing as tolerated, transitioning to regular footwear at two weeks, and gradual return to activity.

Main Results:

Literature review indicates significant patient satisfaction and a low risk of complications with surgical intervention.
Studies report improvements in American Orthopaedic Foot and Ankle Score (AOFAS) scores, with minimal need for additional procedures like flexor hallucis longus (FHL) transfer.
Early weight-bearing protocols show promise for improving visual analog scale (VAS) and AOFAS scores, although wound breakdown is a potential risk.

Conclusions:

The Achilles suture bridge technique with early weight-bearing is a feasible surgical option for managing Haglund deformity and insertional Achilles tendinopathy.
This approach is recommended for patients who have not responded to conservative management strategies.