Haglund's Deformity and Chronic Achilles Tendonitis

Haglund's deformity is characterized as an enlarged prominence of the superior aspect of the posterior calcaneus, which can cause painful inflammation within the retrocalcaneal bursa and anterior surface of the Achilles tendon as a result of mechanical irritation. This may ultimately lead to the development of insertional Achilles tendinopathy. Operative treatment is indicated if conservative therapy, including shoe wear modification, physical therapy, and newer modalities including shockwave therapy, fails to relieve the pain. Endoscopic surgery has the advantages of fewer complications and shorter recovery times in comparison with the open technique. Endoscopic calcaneoplasty is performed using 2 portals, through which the Haglund's prominence and the degenerative portion of the anterior Achilles tendon are debrided, providing better visualization compared to the open procedure. Endoscopic surgery has demonstrated good to excellent outcomes in the short to medium term. This article describes technique of endoscopic calcaneoplasty and Achilles tendoscopy.