PMID- 36033171
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220830
IS  - 2666-061X (Electronic)
IS  - 2666-061X (Linking)
VI  - 4
IP  - 4
DP  - 2022 Aug
TI  - Fluoroscopic and Endoscopic Calcaneal Exostosis Resection and Achilles Tendon 
      Debridement for Insertional Achilles Tendinopathy Results in Good Outcomes, Early 
      Return to Sports Activities, and Few Wound Complications.
PG  - e1385-e1395
LID - 10.1016/j.asmr.2022.04.027 [doi]
AB  - PURPOSE: To review the outcomes of patients with insertional Achilles 
      tendinopathy who underwent a minimally invasive surgery: fluoroscopic and 
      endoscopic calcaneal exostosis resection and Achilles tendon debridement. 
      METHODS: The medical records of consecutive patients who underwent this surgery 
      from February 2017 to July 2019 were reviewed. The inclusion criterion was 
      >/=2-year follow-up. The exclusion criterion was another surgery performed on the 
      ipsilateral or contralateral foot. Haglund deformity resection was not combined 
      with this surgery. The outcomes were assessed using the visual analog scale (VAS) 
      score and the Japanese Society for Surgery of the Foot (JSSF) scores for all 
      patients and the Victorian Institute of Sport Assessment self-administered 
      Achilles (VISA-A) scores for patients participating in sports activities. The 
      Wilcoxon signed-rank test and the thresholds of minimal clinically important 
      difference (MCID) and patient acceptable symptom state (PASS) were used for 
      statistical analyses. RESULTS: Forty-four patients with a mean age of 55.7 +/- 11.0 
      years and mean body mass index of 26.0 +/- 4.0 kg/m(2) were included. The mean 
      follow-up duration was 2.8 +/- 0.7 years. Of all participants, 22 participated in 
      sports activities. The overall median VAS and JSSF scores improved from 64.5 to 
      6.5 mm and from 67.0 to 100 points, respectively (P < .001). The percentages of 
      patients who achieved the MCID for the VAS, JSSF, and VISA-A scores were 100%, 
      93.2%, and 100%, respectively, and the percentages of patients who achieved the 
      PASS for the VAS, JSSF, and VISA-A scores were 77.3%, 86.4%, and 81.8%, 
      respectively. The median VISA-A scores improved from 40.5 to 95.0 points (P < 
      .001). The median time to return to sport was 4.5 months. Complications included 
      five cases of reoperation and two cases of scar sensitivity. CONCLUSION: For 
      patients with insertional Achilles tendinopathy, fluoroscopic and endoscopic 
      calcaneal exostosis resection and Achilles tendon debridement resulted in good 
      outcomes, early return to sports activities, and few wound complications. LEVEL 
      OF EVIDENCE: IV, therapeutic case series.
CI  - (c) 2022 The Authors.
FAU - Nakajima, Kenichiro
AU  - Nakajima K
AD  - Department of Orthopedic Surgery, Yashio Central General Hospital, Saitama, 
      Japan.
LA  - eng
PT  - Journal Article
DEP - 20220609
PL  - United States
TA  - Arthrosc Sports Med Rehabil
JT  - Arthroscopy, sports medicine, and rehabilitation
JID - 101765256
PMC - PMC9402468
EDAT- 2022/08/30 06:00
MHDA- 2022/08/30 06:01
PMCR- 2022/06/09
CRDT- 2022/08/29 04:50
PHST- 2021/09/17 00:00 [received]
PHST- 2022/04/24 00:00 [accepted]
PHST- 2022/08/29 04:50 [entrez]
PHST- 2022/08/30 06:00 [pubmed]
PHST- 2022/08/30 06:01 [medline]
PHST- 2022/06/09 00:00 [pmc-release]
AID - S2666-061X(22)00070-0 [pii]
AID - 10.1016/j.asmr.2022.04.027 [doi]
PST - epublish
SO  - Arthrosc Sports Med Rehabil. 2022 Jun 9;4(4):e1385-e1395. doi: 
      10.1016/j.asmr.2022.04.027. eCollection 2022 Aug.