Endoscopic Calcaneoplasty

Abstract

Endoscopic calcaneoplasty offers access to the retrocalcaneal space, thereby making it possible to remove inflamed retrocalcaneal bursa as well as the posterosuperior part of the calcaneus in applicable cases of painful hindfoot. In this study, endoscopic calcaneoplasty was performed in 21 procedures in 20 patients. All of the patients had typical complaints of inflammation of the retrocalcaneal bursa that were unresponsive to nonoperative treatment for more than 6 months. In all patients a superior calcaneal angle of more than 75 degrees and positive parallel pitch lines were present on the lateral calcaneal radiograph. The mean follow-up was 3.9 years (range, 2 to 6.5). There were no surgical complications and no postoperative infections. One patient had a fair result, 4 patients had good results, and the remaining 15 patients had excellent results. Whether this operation is performed by endoscopic or open technique, enough bone must be removed to prevent impingement of the bursa between the calcaneus and Achilles tendon. Endoscopic calcaneoplasty is a minimally invasive technique performed in an outpatient setting and combined with a functional rehabilitation program. The procedure has low morbidity. Patients have a short recovery time and quickly resume work and sports.

Endoscopic calcaneoplasty (ECP) as a surgical treatment of Haglund’s syndrome

“…This score was chosen for comparing the results with other references [37]. Thirty-four patients presented good and 41 patients excellent The three patients with the poor results showed an ossified area of the Achilles tendon insertion (Fig.…”

The Achilles Tendon Insertion is Crescent-shaped: An In Vitro Anatomic Investigation

“…Dissections from cadaveric studies suggested the medial column of the Achilles tendon, the plantaris tendon, and the sural nerve are at risk in open and in endoscopic surgery [23,46]. Endoscopic retrocalcaneal decompression seems to be a promising method, and success rates greater than 90% have been reported in some case series [14,31,43]. Results of endoscopic and open Haglund's resection were similar in one comparative nonrandomized prospective case series with a success rate of 80% [21].…”

“…This entity was first described by Patrick Haglund in 1928 [24,31,43]. It is characterized clinically by localized pain and swelling at the medial and lateral distal Achilles tendon border resulting from retrocalcaneal bursitis.…”

“…It is characterized clinically by localized pain and swelling at the medial and lateral distal Achilles tendon border resulting from retrocalcaneal bursitis. A prominent posterosuperior calcaneal tuberosity is believed to be the initiating mechanical cause leading to a retrocalcaneal bursa impingement against the corresponding anterior Achilles tendon border [24,31,43]. A rigid posterior shoe counter is believed another inducing factor [11].…”

“…A rigid posterior shoe counter is believed another inducing factor [11]. Because of different therapies, some authors recommend differentiating Haglund's disease from Achilles tendinopathy [22,31,36,43] and from Achilles insertional tendinopathy [22,26,37].…”