Surgical Management of Insertional Achilles Tendinopathy with Haglund's Deformity: A Preliminary Report

Abstract

Purpose: We wanted to report on treatment outcomes in insertional Achilles tendinopathy patients with Haglund's deformity that were operated on using a central achilles tendon splitting approach. Materials and Methods: We enrolled six cases of insertional tendinopathy with concomitant Haglund's disease who underwent an operation between January, 2007 and November, 2008 and for whom follow-up duration for more than 1 year were available. The mean age was 41.5 (21-62) years; the mean follow-up period was 16.3 (12-24) months. Resection of retrocalcaneal bony prominences and inflamed bursa with debridement of degenerative tendons was done using central splitting approach in all cases. A lateral ankle radiograph was used to assess the amount of bony resection. Clinical and functional evaluations were done before and after the operation. Results: In all cases, retrocalcaneal bony prominences were completely resected. Clinical and functional outcomes were significantly improved. One case had a mild tingling distal to the operative lesion. There were no other complications. Conclusion: A central splitting approach is an efficient procedure that can provide sufficient exposure to remove pathologic lesions in patients with insertional Achilles tendinopathy accompanying Haglund's disease.