The advantage of endoscopic treatment of Haglund's syndrome with the three-portal technique

Abstract

Introduction/Objective. Heel deformity accompanied by pain at the attachment of the Achilles tendon is generally known as Haglund?s syndrome. The prominence of the posterosuperior part of the heel bone generates pressure on the retrocalcaneal bursa and Achilles tendon, causing swelling and pain. The condition itself can be treated using surgical or non-surgical methods. The aim was to present our first experiences in the endoscopic treatment of Haglund?s syndrome, employing the three-portal technique. Methods. This study includes ten patients whose surgeries were performed during the period between January 2019, and May 2020. All interventions were endoscopic with the three-portal technique used. The diagnosis was made based on the anamnesis, clinical examination, X-rays, and magnetic resonance imaging diagnostics. For the evaluation of results, the AOFAS (American Orthopedic Foot and Ankle Society) score was used. Results. The endoscopic findings in all patients revealed a hypertrophic retrocalcaneal bursa and prominence at the posterosuperior part of the calcaneus, generating pressure on the Achilles tendon. By employing the three-portal technique, considerably better visualization is obtained, enabling easy removal of the degenerated tissue. The radiographic control image was satisfactory. The result of the AOFAS score showed a significant improvement after the surgery. Conclusion. The endoscopic approach and the use of the three-portal technique in resolving Haglund?s syndrome is a secure procedure that produces good results. It enables faster recovery and fewer complications compared to open surgery.