The effect of anchor use on the clinical and functional outcomes of patients performed haglund surgery with tendon split approach DUE to insertional calcifications

Objective: The main objective of this study is to investigate the effect of calcific debris in the Achilles insertion on the clinical and functional outcomes of patients who underwent Haglund surgery with the tendon split approach. Materials and Methods: We retrospectively evaluated 27 patients (7 men, 20 women) who underwent Haglund's surgery with the tendon split approach in our clinic between 2015 and 2023. Each of the 13 patients with insertional calcific tendinopathy (ICT) was repaired with an anchor suture after partial tendon releasing. Tendon releasing was not applied to 14 patients without ICT. In this study, patients were divided into two groups according to the presence of ICT in the Achilles tendon. Clinical and functional results of these two groups were compared by preoperative and postoperative AOFAS, FADI and VAS scores. Plantar flexion and dorsiflexion strengths of the patients were measured with an isokinetic dynamometer device and compared. The relationship with ICT was investigated by comparing the measurements made from the preoperative x-rays of the patients. Results: As a result of statistical analysis, age, gender and BMI values were found to be similar between the two groups. There was no statistically significant difference between the two groups in preoperative and postoperative AOFAS, FADI and VAS scores. However, when the groups were considered separately, a significant difference was observed between preoperative and postoperative scores in both groups. It was found that the amount of intratendon calcification did not show a significant difference in any of the preoperative and postoperative scores. It was observed that FPA, CPA, HDH, HDHR, HDPA, CLA, BH, BCR values measured preoperatively did not differ between these two groups. It was found that there was no significant difference between the two groups in the values measured by isokinetic dynamometer. Conclusion: Excellent results and high patient satisfaction were observed in all patients who underwent Haglund surgery with the tendon split approach. It was concluded that the presence of calcific tendinopathy did not worsen the clinical condition and did not affect the success of treatment. It was observed that there would be no decrease in plantar flexion strength in patients whose Achilles tendon was partially released from its insertion and repaired with an anchor suture.