Percutaneous Zadek osteotomy for the treatment of insertional Achilles tendinopathy

Nordio, Andrea; Chan, Jimmy J.; Guzman, Javier Z.; Hasija, Rohit; Vulcano, Ettore

doi:10.1016/j.fas.2019.10.011

Cited by 34 publications

(61 citation statements)

References 26 publications

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“…Fifteen of 18 patients said they would recommend the procedure to a family member or friend. Another case series found significant improvements in VAS pain and FFI scores from the DCWCO procedure 43 . Georgiannos et al looked at DCWCO outcomes for 52 professional and recreational athletes with IAT (mean age of 32.5 years).…”

Section: Continuedmentioning

confidence: 95%

Functional Outcomes of Insertional Achilles Tendinopathy Treatment

Jarin

Bäcker

2021

JBJS Reviews

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Background: Achilles tendinopathy is a common clinical problem that can be either insertional or noninsertional, and effective treatment of each type can vary. We sought to investigate the current evidence on different treatment methods for insertional Achilles tendinopathy with a focus on functional outcomes.Methods: We performed a systematic review of the available literature using the PubMed/MEDLINE and Cochrane Central Register of Controlled Trials databases. Data from included studies were categorized according to treatment method and reported with respect to functional outcomes and complications.Results: A total of 1,457 abstracts were reviewed; 54 studies with 2,177 patients met the inclusion criteria. Among the 54 studies, 6 operative techniques and 6 nonoperative treatments were evaluated.Conclusions: Eccentric exercises and low-energy extracorporeal shockwave therapy (ESWT) have the greatest evidence for the initial management of insertional Achilles tendinopathy. ESWT has been increasingly studied in recent years, but more high-quality evidence is needed. Operative treatment with tenotomy, debridement, retrocalcaneal bursectomy, and calcaneal exostectomy is effective. Flexor hallucis longus tendon transfer may benefit cases of more severe disease. Minimally invasive procedures have a potential role in the treatment algorithm and require more rigorous study.

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Section: Continuedmentioning

confidence: 95%

Functional Outcomes of Insertional Achilles Tendinopathy Treatment

Jarin

Bäcker

2021

JBJS Reviews

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“…When conservative measures fail, operative treatment for Achilles tendinopathy may include the open approach, percutaneous approach, or endoscopic approach. 15 , 16 , 17 The endoscopic approach has been shown to allow for better operative control than the percutaneous technique and to yield fewer complications than the open approach. 11 , 18 Endoscopy has been described as a safe treatment for Achilles tendinopathy, allowing for the treatment of diffuse Achilles tendinopathy and concomitant paratenon involvement.…”

Section: Discussionmentioning

confidence: 99%

Achilles Paratenon Needle Tendoscopy in the Office Setting

Mercer

Gianakos

Kaplan

et al. 2022

Arthroscopy Techniques

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“…The DCWCO changes the anatomical length of the calcaneus, and it elevates the distal insertional point of the calcaneal tendon to induce a mechanical advantage, consequently alleviating pain and permitting a fast recovery [1,13,24].…”

Section: Discussionmentioning

confidence: 99%

“…A minimally invasive calcaneal osteotomy (MICO) technique can be performed through a small stab incision measuring approximately 5 mm, which has the potential advantages of minimizing soft tissue dissection [9]. The DCWCO changes the anatomical length of the calcaneus and elevates the distal insertional point of the calcaneal tendon to induce a mechanical advantage, consequently alleviating pain and permitting a fast recovery [1,13,24]. The osteotomy is increasingly used because it does not affect the insertion of the tendon.…”

Section: Introductionmentioning

confidence: 99%

Calcaneal osteotomy due to insertional calcaneal (Achilles) tendinopathy – preoperative planning

Mazura

Goldman

Popelka

et al. 2022

Preprint

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Purpose Dorsal closing wedge calcaneal osteotomy (DCWCO) is indicated in patients with insertional tendinopathy of the calcaneal (Achilles) tendon. The Chauveaus-Liet's (CL) angle is represented by the difference between the angle of verticalization (α) and morphological angle (β) of the calcaneus (CL angle = α − β). The purpose of the study was to assess whether the DCWCO affects the Chauveaus-Liet's angle. Methods The study included 12 patients indicated to DCWCO. Three directions of close wedge osteotomy were designed for each patient—horizontal, vertical and in the middle type of osteotomy and a virtual osteotomy was created in each of them in the ABAQUS system in cooperation with Czech Technical University. The most used directions of osteotomy according to the available literature were used. We evaluated α and β angles before and after osteotomy, changes of the length plantar aponeurosis and the elevation of distal insertional point of the calcaneal tendon. The changes of grades, median and standard deviation were observed. Results The change of the alfa angle was dependent on the direction of the osteotomy and the change of the beta angle was affected by the size of the osteotomy. The greatest elevation of the distal insertional point of the calcaneal tendon occurred in the horizontal type of the osteotomy. Conclusion Our study shows that the more we want to reduce the tension in the calcaneal tendon, the more we have to perform an osteotomy horizontally. This study could serve as a preoperative guide for osteotomy planning.

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Percutaneous Zadek osteotomy for the treatment of insertional Achilles tendinopathy

Cited by 34 publications

References 26 publications

Functional Outcomes of Insertional Achilles Tendinopathy Treatment

Functional Outcomes of Insertional Achilles Tendinopathy Treatment

Achilles Paratenon Needle Tendoscopy in the Office Setting

Calcaneal osteotomy due to insertional calcaneal (Achilles) tendinopathy – preoperative planning

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