Endoscopic Calcaneoplasty Achieves Excellent Functional Outcomes in Haglund's Deformity.

PURPOSE: To evaluate the functional outcomes of endoscopic calcaneoplasty for patients with Haglund's deformity who are recalcitrant to conservative management and to assess complication rates and the proportion of patients achieving minimal clinically important difference in functional outcome scores.

METHODS

Patients with Haglund's deformity who were treated at our tertiary hospital between July 2020 and October 2024 were evaluated for inclusion. Endoscopic calcaneoplasty was performed with the patient positioned supine. Functional outcomes were assessed using the visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and Foot Function Index (FFI) score preoperatively and postoperatively at final follow-up, with a minimum follow-up of 15 months.

RESULTS

The mean follow-up period was 32.3 months (range, 15-66 months). A total of 68 cases (59 patients, 69 feet) were analyzed for this study. The overall mean age was 54.7 ± 13.8 years. 47.1% were men, whereas 52.9% were women. Preoperatively, patients reported that their mean VAS score was 7.8 ± 1.6, which markedly diminished to 1.2 ± 2.0 postoperatively. The baseline mean AOFAS score was 56.0 ± 13.1, and this improved to 92.1 ± 11.7 after surgery. The mean FFI score also significantly improved from 55.0 ± 23.2 preoperatively to 10.8 ± 18.2 postoperatively. All 3 outcome measures showed statistically significant differences (P < .001). Sex-stratified analysis showed no statistically significant differences across all 3 outcome scores (all P > .05). Most patients achieved the minimal clinically important difference, with 98.5% for VAS, 97.1% for AOFAS, and 89.7% for FFI.

CONCLUSIONS

In patients with Haglund's deformity, treatment with endoscopic calcaneoplasty in a supine position showed consistent and significant postoperative improvements in VAS, AOFAS ankle-hindfoot score, and FFI score, with a low complication rate at a minimum 15-month follow-up.

LEVEL OF EVIDENCE: Level IV, therapeutic case series.