Percutaneous Zadek Osteotomy vs Open Haglund Resection for Insertional Achilles Tendinopathy: Early Outcomes and...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Podiatry

Background:

• Insertional Achilles tendinopathy (IAT) presents management challenges with various surgical interventions available.
• Open midline Achilles tendon-splitting Haglund resection and percutaneous Zadek osteotomy (ZO) are two common surgical approaches for IAT.
• Comparing patient-reported outcomes and complications between these techniques is crucial for guiding clinical decisions.

Purpose of the Study:

• To compare patient-reported outcomes and complication rates between open midline Achilles tendon-splitting Haglund resection and percutaneous Zadek osteotomy (ZO) for IAT.
• To evaluate the effectiveness of each surgical technique in improving function, pain, and mobility.

Main Methods:

• A retrospective comparative study involving patients with IAT ± Haglund deformity.
• Patients underwent either open midline Achilles tendon-splitting Haglund resection or percutaneous ZO.
• Preoperative and postoperative PROMIS scores and complications were analyzed over a minimum 12-month follow-up period.

Main Results:

• Both surgical groups demonstrated significant improvements in PROMIS function, pain, and mobility scores.
• The open Haglund resection group experienced a higher rate of wound complications (25.6%) compared to the percutaneous ZO group (2.9%).
• The difference in wound complications between the two groups was statistically significant (P = .007).

Conclusions:

• Both open midline Achilles tendon-splitting Haglund resection and percutaneous ZO provide clinically meaningful improvements for patients with IAT.
• Percutaneous ZO may be associated with a lower incidence of minor wound complications compared to the open approach.
• These findings should be interpreted with caution due to the study's limitations, including sample size and potential bias.