Description
Endoscopic calcaneoplasty for treatment of Achilles tendinopathy due to Haglünd’s deformity was presented by Van Dijk’s in 2001 with excellent and good results in 19 out of 20 patients 1. Leitze compared it to open technique in 2003 and demonstrated equal or better functional results with shorter operative time and better cosmetic results2.
Visualization and orientation in retrocalcaneal space can be quite difficult and the less experienced surgeons may spend a considerable amount of time resecting and clearing soft tissue and trying to find themselves in place. Deciding how much bone to resect during surgery is also another important issue that influences the final result.
I present a slight modification over original Van Dijk’s technique to help in localization, orientation, improve accuracy of bone resection and decrease Xray exposure. My contribution is simple: just put a K wire into posterior calcaneus marking bone resection limits and use it as beacon during the procedure.
In this video you will also find an animated description of the Sella’s method for preoperative planification of amount of bone resection3 as well as the most important references and video links in order to provide the state of the art information from the gurus in this subject.
After that it shows step by step the details of the technique including K-wire placement, soft tissue clearance, insertional tendinopathy debridement and Haglund’s deformity preparation and resection.
REFERENCES
1. van Dijk CN, van Dyk GE, Scholten PE, Kort NP. Endoscopic calcaneoplasty. Am J Sports Med. 2001;29(2):185-189.
2. Leitze Z, Sella EJ, Aversa JM. Endoscopic decompression of the retrocalcaneal space. J Bone Joint Surg Am. 2003;85-A(8):1488-1496.
3. Sella EJ, Caminear DS, McLarney EA. Haglund's syndrome. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. 1998;37(2):110-114; discussion 173.
