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Retrocalcaneal Enthesophyte Resection With Functional Lengthening of the Achilles Tendon and Buried Knot Technique: A Case Series.

MedStar author(s):

Citation: Journal of Foot & Ankle Surgery. 60(6):1308-1314, 2021 Nov-Dec.PMID: 34389217Institution: MedStar Washington Hospital CenterDepartment: Podiatric Surgery ResidencyForm of publication: Journal ArticleMedline article type(s): Case ReportsSubject headings: *Achilles Tendon | *Exostoses | *Tendinopathy | Achilles Tendon/dg [Diagnostic Imaging] | Achilles Tendon/su [Surgery] | Exostoses/dg [Diagnostic Imaging] | Exostoses/su [Surgery] | Humans | Neoplasm Recurrence, Local | Retrospective StudiesYear: 2021 ISSN:

1067-2516

Name of journal: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle SurgeonsAbstract: Retrocalcaneal exostosis can be debilitating and in severe cases, surgical resection is indicated. Complications can arise from surgical resection of the exostosis and reattachment of the Achilles tendon, including irritation of the suture knot, recurrence of the bony prominence, and dehiscence. The use of a buried knot technique with functional lengthening of the Achilles tendon and gastroc-soleal muscle complex can minimize these complications. Complete detachment of the Achilles tendon allows for aggressive and thorough resection of the exostosis and functional lengthening with reattachment. The buried cruciate knot technique allows for firm reattachment with buried knots to prevent soft tissue irritation. A total of fourteen patients (14 limbs) underwent retrocalcaneal enthesophyte resection with functional Achilles tendon lengthening, (8/14) of which had difficultly wearing shoe gear, (10/14) had edema, and (2/14) had erythema preoperatively. Postoperatively, (11/14) of patients returned to full activities and sports, and (11/14) returned to normal shoe gear. Complications included (1/14) of patients with Achilles tendon avulsion and (3/14) of patients with surgical site dehiscence requiring revisional surgery. Overall, this technique helps prevent short-term complications and long-term recurrence due to the functional lengthening mitigating insertional forces on the Achilles tendon. Copyright (c) 2021 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.All authors: Cates NK, Chen S, Rubin LG, Wagler ECOriginally published: Journal of Foot & Ankle Surgery. 2021 Jul 21Fiscal year: FY2022Fiscal year of original publication: FY2022Digital Object Identifier:

https://dx.doi.org/10.1053/j.jfas.2021.07.010

Date added to catalog: 2021-11-01

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Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	34389217	Available		34389217

Retrocalcaneal exostosis can be debilitating and in severe cases, surgical resection is indicated. Complications can arise from surgical resection of the exostosis and reattachment of the Achilles tendon, including irritation of the suture knot, recurrence of the bony prominence, and dehiscence. The use of a buried knot technique with functional lengthening of the Achilles tendon and gastroc-soleal muscle complex can minimize these complications. Complete detachment of the Achilles tendon allows for aggressive and thorough resection of the exostosis and functional lengthening with reattachment. The buried cruciate knot technique allows for firm reattachment with buried knots to prevent soft tissue irritation. A total of fourteen patients (14 limbs) underwent retrocalcaneal enthesophyte resection with functional Achilles tendon lengthening, (8/14) of which had difficultly wearing shoe gear, (10/14) had edema, and (2/14) had erythema preoperatively. Postoperatively, (11/14) of patients returned to full activities and sports, and (11/14) returned to normal shoe gear. Complications included (1/14) of patients with Achilles tendon avulsion and (3/14) of patients with surgical site dehiscence requiring revisional surgery. Overall, this technique helps prevent short-term complications and long-term recurrence due to the functional lengthening mitigating insertional forces on the Achilles tendon. Copyright (c) 2021 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

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