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Open vs Endoscopic Surgical Treatment for Haglund Deformity: A Systematic Review, Meta-analysis, and Meta-regression
Alex Guedes1,2, Enilton de Santana Ribeiro de Mattos1,2, Eduardo Silva Reis Barreto1,2
1Orthopedics and Traumatology Research Group, Federal University of Bahia (UFBA), Salvador, Bahia State, Brazil.
Foot & Ankle Orthopaedics
|May 8, 2026
Summary
This review found no significant difference in ankle function or pain between open and endoscopic surgery for Haglund deformity. Open surgery was faster, but both methods had serious bias risks, necessitating further research.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanical Engineering
Background:
- Haglund deformity causes posterior heel pain and Achilles tendinopathy.
- Surgical resection is considered when conservative treatments fail.
- This study compares open and endoscopic surgical techniques for Haglund deformity.
Purpose of the Study:
- To compare clinical and functional outcomes of open versus endoscopic surgery for Haglund deformity.
- To evaluate postoperative ankle function, operative time, pain, and adverse events.
- To synthesize current evidence on surgical management of Haglund deformity.
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines.
- Included randomized trials and observational cohort studies comparing open and endoscopic surgery.
- Analyzed postoperative ankle function (AOFAS, VISA-A), operative time, pain (VAS), and adverse events.
Main Results:
- Five cohort studies with 226 patients were included (127 endoscopic, 99 open).
- No significant difference in postoperative ankle function or pain between techniques.
- Open surgery demonstrated a shorter operative time, but all studies had a serious risk of bias.
Conclusions:
- Current evidence does not show clear superiority of open or endoscopic surgery for Haglund deformity.
- Limitations include study bias and outcome measurement properties.
- High-quality randomized trials with standardized outcomes are needed to guide surgical decisions.
