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Endoscopic resection of enthesopathy via a direct midline transtendinous approach with associated reattachment of the Achilles tendon (endo-REDMTART): a cadaveric feasibility study

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Abstract

Purpose

The aim of our study was to determine the feasibility of an all-posterior endoscopic resection of enthesopathy via direct midline transtendinous approach with detachment and reattachment of the Achilles tendon (endo-REDMTART).

Materials & methods

Endo-REDMTART was performed in 10 ankles by two foot and ankle surgeons. Posterolateral and posteromedial portals were utilized. Three accessory, more distal portals were utilized (one posterolateral, one posteromedial, and one midline transtendinous). We measured the quality of the resection of the calcaneal spur and the length of tendon that was able to be reattached to the calcaneus.

Results

The procedure was successful in all 10 cases. The mean minimum thickness of resected calcaneal spur was 7 mm (5–9 mm) thick, and the mean anteroposterior distance was 23 mm (20–25 mm). In all 10 cases, the maximum distance between the distal Achilles tendon and calcaneus was 1 mm (0–1 mm), with good tendon–bone contact.

Conclusions

The data here suggest that endo-REDMTART is feasible. This procedure provides all of the advantages of endoscopic technique without compromising the efficacy of Haglund deformity resection.

Trial registration

No Clinical Trials Registration or IRB is required.

Level of evidence

Anatomy study; cadaveric dissection.

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Abbreviations

REDMTART:

Resection of enthesopathy via a direct midline transtendinous approach associated with a reattachment of the tendon

AT:

Achilles tendinopathy

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not for profit sectors. None of the authors, or any member of their family, have received any financial remuneration related to the subject of the article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hôpital Pellegrin, Place Amélie Raba-léon, 33076, Bordeaux, France

    P. Laumonerie

  2. I2R, Institut de Recherche Riquet, 31059, Toulouse, France

    L. Mattesi & D. Ancelin

  3. Anatomy Laboratory, Faculty of Medicine, 31062, Toulouse, France

    L. Mattesi, Chaynes Patrick & D. Ancelin

  4. Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA

    M. E. Tibbo

Authors
  1. P. Laumonerie
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  2. L. Mattesi
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  3. Chaynes Patrick
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  4. M. E. Tibbo
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  5. D. Ancelin
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Contributions

PL contributed to conception and design, statistical analysis, critical revisions, manuscript review; LM contributed to conception and design, data acquisition, analysis and interpretation, statistical analysis, manuscript review; MET helped in statistical analysis, manuscript review; DA helped in conception and design, data acquisition, analysis and interpretation, critical revisions, manuscript review, approved final version of paper, administration, study supervision.

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Correspondence to P. Laumonerie.

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The authors report no conflict of interest with respect the materials or methods used in this study or the findings specified herein.

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David Ancelin certify that this manuscript is a unique submission and is not being considered for publication, in part or in full, with any other source in any medium.

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Laumonerie, P., Mattesi, L., Patrick, C. et al. Endoscopic resection of enthesopathy via a direct midline transtendinous approach with associated reattachment of the Achilles tendon (endo-REDMTART): a cadaveric feasibility study. Eur J Orthop Surg Traumatol 32, 1237–1245 (2022). https://doi.org/10.1007/s00590-021-03098-7

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  • DOI: https://doi.org/10.1007/s00590-021-03098-7

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