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

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.