Percutaneous Zadek Osteotomy vs Open Haglund Resection for Insertional Achilles Tendinopathy: Early Outcomes and Complication Rates

Abstract

Background: Insertional Achilles tendinopathy (IAT) is difficult to manage despite multiple surgical options. Two of the surgical options include an open midline Achilles tendon–splitting Haglund resection and a percutaneous Zadek osteotomy (ZO). The current study compared the patient-reported outcomes and complications of open vs percutaneous procedures in patients with IAT ± Haglund deformity. Methods: A retrospective comparative study of consecutive patients who underwent either an open midline Achilles tendon–splitting Haglund resection or percutaneous ZO for IAT ± Haglund deformity at a single institution with minimum 12 months’ follow-up was performed. Preoperative and postoperative Patient-Reported Outcome Measurement Information System (PROMIS) scores and complications were recorded for each patient and compared between cohorts. Results: Forty-three patients were treated with an open midline Achilles tendon–splitting Haglund resection and 34 patients were treated with a percutaneous ZO for IAT ± Haglund deformity. PROMIS function (P < .001), pain (P < .001), and mobility (P