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Early Outcomes With Early Weightbearing Using Willits Protocol Following Haglund's Surgery.

Bryanna D Vesely1, Brennan K Reardon1, Aaron T Scott1

  • 1*Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC.

Journal of the American Podiatric Medical Association
|June 26, 2025
PubMed
Summary
This summary is machine-generated.

Early mobilization using the Willits protocol after insertional Achilles tendinopathy surgery significantly reduced pain. This approach demonstrated a low reoperation rate, allowing patients to move sooner than traditional methods.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Foot and Ankle Surgery

Background:

  • Insertional Achilles tendinopathy is a prevalent condition requiring surgical intervention.
  • Current postoperative protocols lack standardization, leading to variability in patient outcomes.
  • Detachment and reattachment of the Achilles tendon with partial calcanectomy show promise but require optimized rehabilitation.

Purpose of the Study:

  • To retrospectively evaluate the efficacy of the Willits protocol for early mobilization in patients undergoing surgery for insertional Achilles tendinopathy.
  • To assess pain reduction, reoperation rates, and overall patient outcomes with this early mobilization strategy.
  • To establish a well-defined postoperative protocol for insertional Achilles tendinopathy procedures.

Main Methods:

  • A retrospective chart review of 25 patients (29 feet) treated for insertional Achilles tendinopathy with Haglund's deformity.
  • Surgical intervention involved detachment and reattachment of the Achilles tendon with partial calcanectomy.
  • Postoperative care included the initiation of the Willits protocol for early mobilization, with radiographic and clinical evaluations.

Main Results:

  • Significant postoperative pain reduction was observed, decreasing from an average of 6.14 to 1.53 on a 10-point scale.
  • A low reoperation rate of 10.3% was recorded, with reasons including infection, tendon rupture, and calf tightness.
  • One patient (3.4%) experienced a postoperative rupture following trauma, highlighting a potential complication.

Conclusions:

  • The Willits protocol, originally designed for Achilles tendon ruptures, is effective for early mobilization after insertional Achilles tendinopathy surgery.
  • This protocol leads to improved patient pain levels and a low reoperation rate.
  • Early mobilization with the Willits protocol offers a viable and potentially superior alternative to traditional, more restrictive postoperative regimens.