Percutaneous Zadek Osteotomy for Insertional Achilles Tendinopathy and Haglund Deformity: A Technique Tip

Kaplan, Jonathan; Hall, SarahRose; Schipper, Oliver N.; Vulcano, Ettore; Jackson, J. Benjamin; Gonzalez, Tyler

doi:10.1177/10711007231181124

Cited by 6 publications

(12 citation statements)

References 9 publications

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“… 14 , 47 In the setting of more advanced IAT (with or without HD), a percutaneous Zadek osteotomy can offer significant improvement in pain and function, with a low complication rate. 10 , 29 , 49 In these patients, open debridement is also a reasonable option. Finally, when patients present with attritional Achilles lengthening or extensive Achilles degeneration (>50%), an open reconstruction with or without a flexor hallucis longus (FHL) tendon transfer may be warranted.…”

Section: Treatmentmentioning

confidence: 99%

“…A plantar hinge of 5-8 mm should be preserved to minimize plantar cortex violation and fracture, which potentially increases risk of nonunion. 12 , 22 , 29 , 49 …”

Section: Treatmentmentioning

confidence: 99%

“…Although several osteotomy techniques have been described in the literature, we prefer the technique described by Kaplan et al 29 This technique includes percutaneous wires that act as a cutting guide for the osteotomy, as well as a system for cutting the dorsal wedge ( Figure 6 ). In their technique, Kaplan et al describe the quadrants in 2 planes, coronal and sagittal.…”

Section: Treatmentmentioning

confidence: 99%

“…Next, the surgeon will remove the middle posterior third and the middle anterior third, followed by the dorsal posterior third and dorsal anterior third. 29 …”

Section: Treatmentmentioning

confidence: 99%

“… (A) Sagittal and (B) axial schematic drawings of quadrant cut guide for percutaneous Zadek osteotomy as provided by Kaplan et al 29 …”

Section: Treatmentmentioning

confidence: 99%

See 4 more Smart Citations

Minimally Invasive Approaches to Haglund’s Deformity and Insertional Achilles Tendinopathy: A Contemporary Review

Hall,

Kaplan,

Schipper

et al. 2024

Foot Ankle Int.

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Section: Treatmentmentioning

confidence: 99%

“…A plantar hinge of 5-8 mm should be preserved to minimize plantar cortex violation and fracture, which potentially increases risk of nonunion. 12 , 22 , 29 , 49 …”

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

“…Next, the surgeon will remove the middle posterior third and the middle anterior third, followed by the dorsal posterior third and dorsal anterior third. 29 …”

Section: Treatmentmentioning

confidence: 99%

“… (A) Sagittal and (B) axial schematic drawings of quadrant cut guide for percutaneous Zadek osteotomy as provided by Kaplan et al 29 …”

Section: Treatmentmentioning

confidence: 99%

See 3 more Smart Citations

Minimally Invasive Approaches to Haglund’s Deformity and Insertional Achilles Tendinopathy: A Contemporary Review

Hall,

Kaplan,

Schipper

et al. 2024

Foot Ankle Int.

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The surgical learning curve for percutaneous Zadek osteotomy for treatment of insertional achilles tendinopathy

Hall,

Kaplan,

Phillips

et al. 2024

Arch Orthop Trauma Surg

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Introduction The Zadek Osteotomy has been described as an effective technique for the treatment of insertional Achilles tendinopathy. Recently, this strategy has been modified using minimally invasive techniques. A learning curve has been observed in many minimally invasive procedures in foot and ankle surgery. This retrospective study first intended to evaluate if there is a learning curve associated with the percutaneous Zadek Osteotomy. Further, if a learning curve was observed, we planned to assess the data for associated changes in complications and postoperative outcomes. Methods A retrospective analysis of 98 patients who underwent percutaneous Zadek Osteotomy was performed. Patient charts were reviewed for operative times, complications, union rates, and Foot Function Index (FFI) and Visual Analogue Scale (VAS) scores. Analysis of variance was utilized to assess for differences between groups of cases. Results Patients included 61 females and 37 males. Mean age was 51.28 ± 11.12 (range 28–81) years. Mean follow-up time was 42.07 ± 12.99 (range 24–65) months. Significant increases in operative times were observed in cases 1–14 when compared to cases 15–98 (p < 0.001). Improvements in FFI and VAS scores were observed at final follow-up within each case group (p < 0.001); there were no differences detected in FFI or VAS scores between groups of cases. There was no difference detected in number of complications between intervals of cases. Conclusion A learning curve was observed for the percutaneous Zadek Osteotomy, which was overcome around case 14. This learning curve was only observed in terms of procedure length. A surgeon’s level of inexperience with the technique does not appear to affect functional outcomes, nonunion, or need for revision. Level of evidence IV Data will not be deposited in a repository.

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Dorsal calcaneal wedge removal in zadek osteotomy: A cadaveric study

Kaplan,

Hall,

Kumar

et al. 2024

Foot and Ankle Surgery

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Percutaneous Zadek Osteotomy for Insertional Achilles Tendinopathy and Haglund Deformity: A Technique Tip

Cited by 6 publications

References 9 publications

Minimally Invasive Approaches to Haglund’s Deformity and Insertional Achilles Tendinopathy: A Contemporary Review

Minimally Invasive Approaches to Haglund’s Deformity and Insertional Achilles Tendinopathy: A Contemporary Review

The surgical learning curve for percutaneous Zadek osteotomy for treatment of insertional achilles tendinopathy

Dorsal calcaneal wedge removal in zadek osteotomy: A cadaveric study

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