The surgical learning curve for percutaneous Zadek osteotomy for treatment of insertional achilles tendinopathy.
Haglund syndrome
Insertional achilles tendinopathy
Learning curve
Minimally invasive surgery
Zadek osteotomy
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
26 Jun 2024
26 Jun 2024
Historique:
received:
08
03
2024
accepted:
12
06
2024
medline:
27
6
2024
pubmed:
27
6
2024
entrez:
26
6
2024
Statut:
aheadofprint
Résumé
The Zadek Osteotomy has been described as an effective technique for the treatment of insertional Achilles tendinopathy. Recently, this strategy has been modified using minimally invasive techniques. A learning curve has been observed in many minimally invasive procedures in foot and ankle surgery. This retrospective study first intended to evaluate if there is a learning curve associated with the percutaneous Zadek Osteotomy. Further, if a learning curve was observed, we planned to assess the data for associated changes in complications and postoperative outcomes. A retrospective analysis of 98 patients who underwent percutaneous Zadek Osteotomy was performed. Patient charts were reviewed for operative times, complications, union rates, and Foot Function Index (FFI) and Visual Analogue Scale (VAS) scores. Analysis of variance was utilized to assess for differences between groups of cases. Patients included 61 females and 37 males. Mean age was 51.28 ± 11.12 (range 28-81) years. Mean follow-up time was 42.07 ± 12.99 (range 24-65) months. Significant increases in operative times were observed in cases 1-14 when compared to cases 15-98 (p < 0.001). Improvements in FFI and VAS scores were observed at final follow-up within each case group (p < 0.001); there were no differences detected in FFI or VAS scores between groups of cases. There was no difference detected in number of complications between intervals of cases. A learning curve was observed for the percutaneous Zadek Osteotomy, which was overcome around case 14. This learning curve was only observed in terms of procedure length. A surgeon's level of inexperience with the technique does not appear to affect functional outcomes, nonunion, or need for revision. Data will not be deposited in a repository.
Identifiants
pubmed: 38926196
doi: 10.1007/s00402-024-05405-3
pii: 10.1007/s00402-024-05405-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Maffulli N, Saxena A, Wagner E, Torre G (2019) Achilles insertional tendinopathy: state of the art. J ISAKOS 4:48–57. https://doi.org/10.1136/JISAKOS-2017-000144
doi: 10.1136/JISAKOS-2017-000144
Nordio A, Chan JJ, Guzman JZ et al (2020) Percutaneous Zadek osteotomy for the treatment of insertional Achilles tendinopathy. Foot Ankle Surg 26:818–821. https://doi.org/10.1016/J.FAS.2019.10.011
doi: 10.1016/J.FAS.2019.10.011
pubmed: 31784097
Kaplan J, Hall S, Schipper O et al (2023) Percutaneous Zadek Osteotomy for Insertional Achilles Tendinopathy and Haglund’s deformity: a technique tip. Foot Ankle Int
Choi JY, Jin;, Suh S, Hindfoot C (2022) A Novel Technique of Minimally Invasive Calcaneal Osteotomy for Intractable Insertional Achilles Tendinopathy Associated with Haglund Deformity. https://doi.org/10.1177/2473011421S006187:2473011421S0061 . https://doi.org/10.1177/2473011421S00618
deMeireles AJ, Guzman JZ, Nordio A et al (2022) Complications after Percutaneous osteotomies of the Calcaneus. Foot Ankle Orthop 7. https://doi.org/10.1177/24730114221119731/ASSET/IMAGES/LARGE/10.1177_24730114221119731-FIG4.JPEG
Mazura M, Goldman T, Stanislav P et al (2022) Calcaneal osteotomy due to insertional calcaneal tendinopathy: preoperative planning. J Orthop Surg Res 17:1–5. https://doi.org/10.1186/S13018-022-03359-Z/TABLES/2
doi: 10.1186/S13018-022-03359-Z/TABLES/2
Jerosch J, Schunck AJ, Sokkar ASH Endoscopic calcaneoplasty (ECP) as a surgical treatment of Haglund’s syndrome. https://doi.org/10.1007/s00167-006-0279-3
Leitze Z, Sella EJ, Aversa JM (2003) Endoscopic decompression of the retrocalcaneal space. J Bone Joint Surg Am 85:1488–1496. https://doi.org/10.2106/00004623-200308000-00009
doi: 10.2106/00004623-200308000-00009
pubmed: 12925628
Ortmann FW, McBryde AM (2016) Endoscopic bony and soft-tissue decompression of the retrocalcaneal space for the treatment of haglund deformity and retrocalcaneal bursitis. http://dx.doi.org/103113/FAI20070149 28:149–153. https://doi.org/10.3113/FAI.2007.0149
Scholten PE, van Dijk CN (2006) Endoscopic calcaneoplasty. Foot Ankle Clin 11:439–446. https://doi.org/10.1016/J.FCL.2006.02.004
doi: 10.1016/J.FCL.2006.02.004
pubmed: 16798522
Jowett CRJ, Bedi HS (2017) Preliminary results and learning curve of the minimally invasive Chevron Akin Operation for Hallux Valgus. J Foot Ankle Surg 56:445–452. https://doi.org/10.1053/j.jfas.2017.01.002
doi: 10.1053/j.jfas.2017.01.002
pubmed: 28237566
Palmanovich E, Ohana N, Atzmon R et al (2020) MICA: a learning curve. J Foot Ankle Surg 59:781–783. https://doi.org/10.1053/J.JFAS.2019.07.027
doi: 10.1053/J.JFAS.2019.07.027
pubmed: 32340840
Jackson JB, Kennedy B, Deal P, Gonzalez T (2021) The Surgical Learning curve for Modified Lapidus Procedure. https://doi.org/10.1177/19386400211029148 . for Hallux Valgus Deformity
Toepfer A, Strässle M (2022) The percutaneous learning curve of 3rd generation minimally-invasive Chevron and Akin osteotomy (MICA). Foot Ankle Surg 28:1389–1398. https://doi.org/10.1016/J.FAS.2022.07.006
doi: 10.1016/J.FAS.2022.07.006
pubmed: 35882575
Ghioldi ME, Chemes LN, Dealbera ED et al (2022) Modified Bösch Osteotomy Combined with a percutaneous adductor Tendon Release for the treatment of Hallux Valgus deformity: learning curve. https://doi.org/10.1177/19386400221079198
Lewis TL, Robinson PW, Ray R et al (2023) The learning curve of Third-Generation Percutaneous Chevron and Akin Osteotomy (PECA) for Hallux Valgus. J Foot Ankle Surg 62:162–167. https://doi.org/10.1053/J.JFAS.2022.06.005
doi: 10.1053/J.JFAS.2022.06.005
pubmed: 35868982
Merc M, Fokter SK, I IS (2023) Learning curve in relation to radiation exposure, procedure duration and complications rate for minimally invasive Chevron Akin (MICA) osteotomy. BMC Musculoskelet Disord 24:1–10. https://doi.org/10.1186/S12891-023-06706-1/TABLES/1
doi: 10.1186/S12891-023-06706-1/TABLES/1
Reddy SC, Schipper ON, Li J (2022) The Effect of Chilled vs Room-Temperature Irrigation on Thermal Energy Dissipation during minimally invasive calcaneal osteotomy of cadaver specimens. https://doi.org/10.1177/24730114221136548/ASSET/IMAGES/LARGE/10.1177_24730114221136548-FIG4.JPEG . Foot Ankle Orthop 7:
Minimally Invasive Surgery Gains Traction Among Foot and Ankle Surgeons https://www.aaos.org/aaosnow/2019/sep/clinical/clinical02/ . Accessed 21 Feb 2023
Frigg A, Zaugg S, Maquieira G, Pellegrino A (2019) Stiffness and range of motion after minimally invasive chevron-akin and open scarf-akin procedures. https://doi.org/10.1177/1071100718818577 .
Chan CX, Gan JZW, Chong HC et al (2019) Two year outcomes of minimally invasive hallux valgus surgery. Foot Ankle Surg 25:119–126. https://doi.org/10.1016/J.FAS.2017.09.007
doi: 10.1016/J.FAS.2017.09.007
pubmed: 29409293
Castellini JLA, Grande Ratti MF, Gonzalez DL (2022) Clinical and radiographic outcomes of percutaneous third-generation double first metatarsal osteotomy combined with closing-wedge proximal phalangeal osteotomy for moderate and severe hallux valgus. https://doi.org/10.1177/10711007221118568