High patient satisfaction and good long-term functional outcome after endoscopic calcaneoplasty in patients with retrocalcaneal bursitis

Abstract

Purpose: The primary objective of this study was to determine the degree of patient satisfaction at a minimum of 5 years of follow-up after endoscopic calcaneoplasty. The secondary objectives were to assess functional outcome measures, pain scores, analysis of bone removal, reformation of exostosis at follow-up and correlation of the size of the exostosis and recurrent or persisting complaints. Methods: This study evaluated patients who underwent endoscopic calcaneoplasty, between January 1st 2000 and December 31st 2010, for the diagnosis of retrocalcaneal bursitis. The evaluation consisted of PROMs (patient-reported outcome measures), a questionnaire and a visit to the outpatient clinic for physical examination and a standard lateral weight-bearing radiograph of the ankle. Patient satisfaction, functional outcomes and pain scores were measured by use of a numeric rating scale (NRS). Size of the posterosuperior calcaneal exostosis was measured on a standard lateral weight-bearing radiograph using parallel pitch lines (PPL) and the Fowler–Philip angle (PFA). Results: The response rate was 28 out of 55 (51%) and the median time to follow-up was 101(IQR 88.5–131.8) months. The median satisfaction score for treatment results was 8.5 out of 10 (IQR 6–10). FAOS symptoms 84.5 (IQR 58.0–96.4), FAOS pain 90.3 (IQR 45.1–100.0), FAOS ADL 94.9 (IQR 58.1–100.0), FAOS sport 90.0 (IQR 36.3–100.0) and FAOS QOL 71.9 (IQR 37.5–93.8) and median AOFAS was 100 (IQR 89–100). The median PLL difference between before operation and 2 weeks after the operation was − 4 mm (IQR-6 and -1) and the median PLL difference between 2 weeks after the operation and at follow-up was 1 mm (0–2). The median PFA was 65 (63–69) at baseline, 66.5 (60.8–70.3) 2 weeks after the operation and 64 (60.8–65.3) at follow-up. Conclusion: Despite the limited response rate, this study shows high patient satisfaction and good long-term functional outcome in patients affected by retrocalcaneal bursitis who underwent endoscopic calcaneoplasty. Level of evidence: Level IV.