University of South Carolina, School of Medicine, Columbia, SC, USA.
Anderson Orthopaedic Clinic, Arlington, VA, USA.
Foot Ankle Int. 2024 Sep;45(9):931-939. doi: 10.1177/10711007241252803. Epub 2024 Sep 1.
Surgical treatment of insertional Achilles tendinopathy (IAT) historically consists of Achilles tendon debridement with reattachment and excision of the posterosuperior calcaneal prominence with or without a gastrocnemius recession. Zadek osteotomy (ZO) is an alternative to an open midline splitting approach. The purpose of this study was to analyze patient-reported outcomes and complications after percutaneously performed ZO with minimum 2 years' follow-up.
One hundred eight cases treated with percutaneous ZO with a minimum 2-year follow-up were retrospectively reviewed. Postoperative complications and patient satisfaction were evaluated. Foot Function Index (FFI) and visual analog scale (VAS) scores were recorded at preoperative and follow-up appointments to measure patients' functional outcomes and pain, respectively.
Mean follow-up was 41.2 months (range, 24-65). Mean age was 51.8 years (range, 28-81). The mean FFI score improved from 56.1 (range, 47-88) to 11.0 (range, 7-59) postoperatively ( < .001). The mean VAS score improved from 7.7 (range, 5-10) to 0.4 (range, 0-7) postoperatively ( < .001). The overall complication rate was 3.8% (n = 4). Of 104 cases, 98.1% of patients said they were satisfied with their procedure (n = 102) when asked if they were satisfied with their ZO and recovery.
We found the percutaneous ZO to be a safe and effective intervention for treatment of IAT. At a minimum of 2-year follow-up, this intervention is associated with minimal complications, improved function, reduced pain, and a high rate of patient satisfaction.
插入性跟腱病（IAT）的手术治疗传统上包括跟腱清创术，以及后上跟骨突出的再附着和切除，同时可伴有或不伴有腓肠肌退缩。Zadek 截骨术（ZO）是一种替代开放性中线切开术的方法。本研究的目的是分析经皮 ZO 治疗后至少 2 年的患者报告结局和并发症。
回顾性分析了 108 例经皮 ZO 治疗的病例，随访时间至少 2 年。评估术后并发症和患者满意度。在术前和随访时记录足部功能指数（FFI）和视觉模拟量表（VAS）评分，分别用于测量患者的功能结局和疼痛。
平均随访时间为 41.2 个月（范围，24-65 个月）。平均年龄为 51.8 岁（范围，28-81 岁）。FFI 评分从术前的 56.1（范围，47-88）改善至术后的 11.0（范围，7-59）（<.001）。VAS 评分从术前的 7.7（范围，5-10）改善至术后的 0.4（范围，0-7）（<.001）。总体并发症发生率为 3.8%（n = 4）。在 104 例病例中，当被问及是否对 ZO 和恢复满意时，98.1%（n = 102）的患者表示满意。
我们发现经皮 ZO 治疗 IAT 是一种安全有效的干预方法。在至少 2 年的随访中，这种干预与最小的并发症、功能改善、疼痛减轻和高患者满意度相关。
