Endoscopic calcaneoplasty for the treatment of Haglund’s deformity provides better clinical functional outcomes, lower complication rate, and shorter recovery time compared to open procedures: a systematic review

Abstract

Purpose The aim of this research is to report the clinical outcome following surgical correction of Haglund's deformity summarising diferent surgical strategies and comparing clinical outcomes, failures, complications and return to activities of patients underwent open and endoscopic techniques. Methods A systematic search of the literature was conducted using eight diferent databases. Thirty-ive studies were included in the systematic review. A total of 1260 ankles of 1147 patients were grouped in accordance with the surgical approach (open, endoscopic, or percutaneous). ResultsThe overall mean age was 44.8 ± 8.2 (range 14.9-82) years with a mean follow-up of 30.9 ± 17.1 (range 3-132) months. Analysis of clinical outcomes of open and endoscopic techniques demonstrated signiicant diferences of AOFAS (87.1 ± 5.9 versus 90.7 ± 4.2 points; P < 0.001), complications (15.5% versus 4.1%; P < 0.001), failures (6.0% versus 1.2%; P < 0.001), time to return to daily activities (17.2 ± 9.3 versus 6.3 ± 1.0 weeks; P < 0.001) and time to return to sport (20.7 ± 3.3 versus 11.9 ± 0.3 weeks; P < 0.001) in the studies that reported these speciic outcome measures. ConclusionSurgical correction of Haglund's deformity provides overall good clinical results and high subjective satisfaction. Endoscopic procedures demonstrated better inal AOFAS, a lower rate of complications and failures, and shorter recovery time when compared to open techniques. Level of evidence Level IV.

Functional evaluation of patients undergoing endoscopic calcaneoplasty for Haglund deformity

“…Finally, there were no postoperative complications in any of the 24 endoscopic surgeries performed: no Achilles tendon rupture, dehiscence, or sign of Achilles tendon infection were identified, either in the immediate postoperative period or in a period of 18 to 36 months after the procedure. These data are in line with findings described in the literature, as other studies have shown good outcomes in terms of improvement of both pain and function (14,16,19) .…”

“…The results of this study are consistent with those of a systematic review published in November 2020 by the European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA), which found that the correction of Haglund deformity provides a good clinical status and a low complication rate. The endoscopic approach ensures significantly better postoperative AOFAS scores and a faster return to daily activities when compared to open surgery (19) . Finally, there were no postoperative complications in any of the 24 endoscopic surgeries performed: no Achilles tendon rupture, dehiscence, or sign of Achilles tendon infection were identified, either in the immediate postoperative period or in a period of 18 to 36 months after the procedure.…”

Fluoroscopic and Endoscopic Calcaneal Exostosis Resection and Achilles Tendon Debridement for Insertional Achilles Tendinopathy Results in Good Outcomes, Early Return to Sports Activities, and Few Wound Complications

“…Current reports discuss endoscopic Haglund deformity resection as a surgical technique for pathologies associated with Achilles tendon insertion. 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 This method involves an endoscopic dissection of the soft tissue surrounding the Haglund deformity and resection of the bone. 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 However, it should be noted that this technique was entirely different from our technique.…”

“… 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 This method involves an endoscopic dissection of the soft tissue surrounding the Haglund deformity and resection of the bone. 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 However, it should be noted that this technique was entirely different from our technique. Endoscopic Haglund deformity resection has been reported only for Haglund’s disease; no report has discussed the use of endoscopic Haglund deformity resection alone for insertional Achilles tendinopathy.…”

Haglund Syndrome: A Systematic Review of the Current Possible Management

“…In this review, we included 12 studies [8,[26][27][28][29][30][31][32][33][34][35][36] where only study was systematic review [29] . The pooled studies included 1542 patients with Haglund's symptom with mean age 41.98 years old (Standard deviation of 7.1 years, minimum and maximum age of 32.5 and 59.3 years old).…”