Endoscopic Calcaneoplasty by Biportal Technique for Haglund Syndrome: A Case Series

Achilles tendon rupture, scar tenderness, delayed wound healing, and recurrent pain. 4ndoscopic procedures using a biportal or triportal approach are considered superior to open procedures because of a smaller incision leading to lower postoperative complications, early mobilization, faster recovery, and better rehabilitation.The retrocalcaneal space at the bony insertion of the Achilles tendon can be effectively visualized during the procedure. 5an Dijk et al. reported on the clinical outcomes of several patients treated with endoscopic calcaneoplasty in 2001 and stated that this surgery was regarded as an improvement over traditional approaches.In our study, we prospectively evaluated the outcome of biportal endoscopic calcaneoplasty in the treatment of Haglund syndrome. IntroductIonThe term "Haglund deformity", introduced by Patrick Haglund in 1927, refers to an unusual bony prominence located at the posterosuperior aspect of the calcaneum. 1This abnormal prominence can lead to repeated irritation of the retrocalcaneal bursa, resulting in bursitis and Achilles tendinitis.The combination of this bony growth, bursitis, and tendinopathy at the Achilles insertion is collectively known as Haglund syndrome. 2t commonly occurs in middle-aged individuals and can be bilateral.Chief complaints include posterior heel pain, swelling, and limp.The main clinical features include tenderness at the posterior bony prominence with painful active and passive dorsiflexion of ankle joint. 3-rays show the prominent posterosuperior calcaneal tuberosity, while MRI identifies bursal thickening, Achilles tendinopathy, and signal changes at the insertion of the tendo-Achilles.Conservative treatment is the mainstay of treatment and includes activity modification, heel raise, NSAIDs, physiotherapy, or intervention with intralesional platelet-rich plasma therapy.Surgical modalities are considered only on failure of the conservative management and include traditional open calcaneoplasty and endoscopic calcaneoplasty. 4pen procedures use a lateral, medial, or split Achilles tendon approach.These approaches provide adequate exposure for wide resection of the bony prominence but are associated with numerous complications such as wound dehiscence,