Patient-Reported Outcomes After Minimally Invasive vs Open Achilles Tendon Debridement and Haglund Resection
Elinor A. Stern, Sanidhya Singh, Michael Fernandes, Barrie Sugarman, Ian Torchia, John P. Tabb, Erik R. Nakken, Samuel I. Rosenberg, David Walton, James R. Holmes, Paul TalusanBackground:
Operative management of Insertional Achilles tendinopathy (IAT) involves debridement and resection of the Haglund deformity. Open approaches are effective but large incisions carry risks such as wound complications and lengthy recovery times. Minimally invasive (MIS) techniques have been developed; however, literature is limited regarding outcomes of MIS techniques. This study compares patient-reported outcome measures for patients undergoing open vs MIS Achilles debridement and Haglund resection.
Methods:
Patients 18 years of age or older undergoing open or MIS Achilles debridement and Haglund resections by 3 fellowship-trained foot and ankle surgeons at a single institution were identified from January 2018 to December 2025. Demographic data as well as preoperative and postoperative patient-reported outcome (Patient-Reported Outcomes Measurement Information System [PROMIS] physical function and pain interference) scores for function and pain were collected and compared between MIS and open groups.
Results:
Twenty-three patients in the MIS group and 49 patients (undergoing 50 surgeries) in the open group were included. With the numbers available, no significant difference in preoperative PROMIS physical function (
Conclusion:
With the numbers available, no significant difference in postoperative patient-reported outcomes could be detected between MIS Achilles debridement and Haglund resection and standard open approaches at most time points. At 6 weeks postoperatively, patients who had undergone MIS surgery reported better functional outcomes; however, no significant difference in outcomes could be detected at any other time point. No postoperative Achilles ruptures or infections were noted in the MIS group. MIS approaches to treatment for IAT may be a viable alternative to classic open approaches, although the small sample and retrospective design limit this conclusion.
Level of Evidence:
Level III, retrospective comparitive study.