Abstract
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.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: July 21, 2021
Footnotes
Financial Disclosure: No funding was received for the study.
Conflict of Interest: Laurence G. Rubin, DPM, FACFAS reports he is a consultant for Medartis and Vilex, was given an honorarium for the American College of Foot & Ankle Surgeons and International Bone Research Association, and has intellectual property with Wright Medical.
Informed Consent: Informed consent was obtained by all subjects within the study; the study was approved by MedStar Georgetown University Hospital Institutional Review Board and Ethical Committee.
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