Outcome of Calcaneoplasty in Insertional Achilles Tendinopathy

Lim, SM; Yeap, EJ; Lim, YW; Yazid, Mohd Nazri

doi:10.5704/moj.1211.007

Cited by 12 publications

(3 citation statements)

References 24 publications

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“…Specifically, the rate of complications with open surgical debridement for Achilles tendinopathy ranges from 6 to over 30%. [44][45][46][47][48][49] The complication rate for plantar fasciotomy surgery has been reported to range from 4.0 to 4.4%. 50,51 Similarly, a review of endoscopic plantar fascia release reported a complication rate of 6.0%, including paresthesias or numbness, soft tissue healing, and superficial infections.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, in the lower extremities, USG surgical procedures may have a notably lower complication rate than traditional surgical techniques. Specifically, the rate of complications with open surgical debridement for Achilles tendinopathy ranges from 6 to over 30% 44–49 . The complication rate for plantar fasciotomy surgery has been reported to range from 4.0 to 4.4% 50,51 .…”

Section: Discussionmentioning

confidence: 99%

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Three‐Month Complication Rate of Ultrasound‐Guided Soft Tissue Surgical Procedures Across Six Sports Medicine Clinics

Hall,

Kliethermes,

Henning

et al. 2023

J of Ultrasound Medicine

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ObjectivesTo 1) determine the types and frequency of complications within 3 months following ultrasound‐guided surgical procedures, and 2) identify any patient demographics, co‐morbidities, or procedural characteristics that were associated with an increased risk of complications.MethodsA retrospective chart review was performed at six Sports Medicine clinics across the United States. The Clavien‐Dindo classification was used to categorize procedural complications on a 5‐point scale from 1, representing any deviation in post‐procedure care without requiring pharmacological or invasive treatment to 5, representing death. Generalized Estimating Equations for binomial outcomes with a logit link were used to estimate the overall and procedure‐specific 3‐month complication rates.ResultsAmong 1902 patients, 8.1% (n = 154) had diabetes and 6.3% (n = 119) were current smokers. The analysis included 2,369 procedures, which were performed in either the upper extremity (44.1%, n = 1045) or lower extremity (55.2%, n = 1308) regions. The most common procedure was ultrasound‐guided tenotomy (69.9%, n = 1655). Additional procedures included, trigger finger release (13.1%, n = 310), tendon scraping (8.0%, n = 189), carpal tunnel release (5.4%, n = 128), soft tissue release (2.1%, n = 50), and compartment fasciotomy (1.6%, n = 37). Overall, there was a complication rate of 1.2% (n = 29 complications; 95% CI: 0.8–1.7%). Individual procedures had complication rates that ranged from 0 to 2.7%. There were 13 Grade I complications in 13 patients, 12 Grade II complications in 10 patients, 4 Grade III complications in 4 patients, and 0 Grade IV or V complications. No associations between complication risk and any patient demographics (age, sex, BMI), co‐morbidities (diabetes, smoker), or procedure characteristics (type, region) were identified.ConclusionThis retrospective review provides an evidence‐based estimate supporting the low level of risk associated with ultrasound‐guided surgical procedures for patients from a variety of geographical settings who are seeking care at private and academic‐affiliated clinics.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Three‐Month Complication Rate of Ultrasound‐Guided Soft Tissue Surgical Procedures Across Six Sports Medicine Clinics

Hall,

Kliethermes,

Henning

et al. 2023

J of Ultrasound Medicine

View full text Add to dashboard Cite

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“…[2][3][4] However, when there is major intratendinous bone pathology involved, in clinical practice surgery is often warranted. Surgical techniques [5][6][7][8][9][10][11][12][13][14][15][16][17][18] include procedures such as tendon detachment-bone removal-tendon re-attachment and calcaneo-osteotomy. Bone removal via longitudinal tenotomy is an alternative when there is minor bone pathology.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of insertional Achilles tendinopathy: results after removal of the subcutaneous bursa alone—a case series

Alfredson

Spang

2020

BMJ Open Sport Exerc Med

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BackgroundInsertional Achilles tendinopathy is well known to be difficult to treat, especially when there is intra-tendinous bone pathology. This study is a case series on patients with chronic insertional Achilles tendon pain and major intra-tendinous bony pathology together with bursa and tendon pathology, treated with excision of the subcutaneous bursa alone.MethodsEleven patients (eight men and three women) with a mean age of 44 years (range 24–62) and a chronic (>6 months) painful condition from altogether 15 Achilles tendon insertions were included. In all patients, ultrasound examination showed intra-tendinous bone pathology together with pathology in the tendon and subcutaneous bursa, and all were surgically treated with an open excision of the whole subcutaneous bursa alone. This was followed by full weight-bearing walking in a shoe with open heel for 6 weeks.ResultsAt follow-up 21 (median, range 12–108) months after surgery, 9/11 patients (12/15 tendons) were satisfied with the result of the operation and 10/11 (13/15 tendons) were back in their previous sport and recreational activities. The median VISA-A score had improved from 41 (range 0–52) to 91 (range 33–100) (p<0.01).ConclusionIn patients with chronic painful insertional Achilles tendinopathy with intra-tendinous bone pathology, tendon and bursa pathology, open removal of the subcutaneous bursa alone can relieve the pain and allow for Achilles tendon loading activities. The results in this case series highlight the need for more studies on the pain mechanisms in insertional Achilles tendinopathy and the need for randomised studies to strengthen the conclusions.Level of evidenceIV Case series.

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Percutaneous Ultrasonic Tenotomy Reduces Insertional Achilles Tendinopathy Pain With High Patient Satisfaction and a Low Complication Rate

Chimenti

Stover

Fick

et al. 2018

J of Ultrasound Medicine

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Due to the novelty of percutaneous ultrasonic tenotomy, the risks and benefits of this minimally invasive procedure for insertional Achilles tendinopathy pain have only been examined in case studies and retrospective chart reviews for other diagnoses. This retrospective chart review over a 3.5‐year period identified 34 patients with insertional Achilles tendinopathy who had percutaneous ultrasonic tenotomy (mean age ± SD, 52.2 ± 11.6 years; mean body mass index, 32.9 ± 7.5 kg/m2; 62% female). This procedure reduced the rate of moderate/severe pain from 68% at baseline to 15% at the long‐term follow‐up and had a satisfaction rate of 70%. There was 1 minor complication out of 40 procedures in 34 patients.

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Outcome of Calcaneoplasty in Insertional Achilles Tendinopathy

Abstract: Calcaneoplasty, Insertional Achilles tendinopathy, Haglund's deformity.

Cited by 12 publications

References 24 publications

Three‐Month Complication Rate of Ultrasound‐Guided Soft Tissue Surgical Procedures Across Six Sports Medicine Clinics

Three‐Month Complication Rate of Ultrasound‐Guided Soft Tissue Surgical Procedures Across Six Sports Medicine Clinics

Surgical treatment of insertional Achilles tendinopathy: results after removal of the subcutaneous bursa alone—a case series

Percutaneous Ultrasonic Tenotomy Reduces Insertional Achilles Tendinopathy Pain With High Patient Satisfaction and a Low Complication Rate

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