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Review paper

Platelet rich plasma (PRP) in the surgical treatment of Haglund’s syndrome: the use of PRP membranes as an intra-operative local adjuvant

By
Giuseppe Restuccia Orcid logo ,
Giuseppe Restuccia

Department of Orthopaedics, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy

Giorgio Varchetta ,
Giorgio Varchetta

Department of Orthopaedics and Trauma Surgery, University of Pisa, Pisa, Italy

Alessandro Lippi ,
Alessandro Lippi

Department of Orthopaedics, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy

Lorenzo Dolfi ,
Lorenzo Dolfi

Department of Orthopaedics, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy

Federico Bizzocchi ,
Federico Bizzocchi

Department of Orthopaedics and Trauma Surgery, University of Pisa, Pisa, Italy

Stefano Giovannetti ,
Stefano Giovannetti

Department of Orthopaedics and Trauma Surgery, University of Pisa, Pisa, Italy

Edoardo Ipponi
Edoardo Ipponi
Contact Edoardo Ipponi

Department of Orthopaedics and Trauma Surgery, University of Pisa, Pisa, Italy

Abstract

Aim
Haglund's syndrome may be responsible for chronic pain in the ankle and hindfoot. Although numerous therapeutic approaches have been described in the literature, to this date no consensus over a surgical treatment has been established. We report our experience in the treatment of Haglund's syndrome and pre-insertional calcifications of the Achilles tendon using an open surgical approach and platelet rich plasma (PRP) membranes as a local adjuvant.
Methods
The study retrospectively evaluated patients with Haglund syndrome treated with a direct posterior access, Achilles
tendon split, bursectomy, resection of the heel deformity and topical administration of PRP membranes. After surgery, a standardized rehabilitation protocol was performed. The preoperative and postoperative functionalities of the foot and ankle were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score. Intraoperative and postoperative complications were recorded.
Results
Twenty consecutive patients were included. The mean follow-up was 23 months. No patient had major intraoperative or
postoperative complications. After the surgery, the mean AOFAS score increased from 44.1 to 92.0, resulting in a statistically significant increase in patient functionality after the treatment (p=0.001).
Conclusion
Our results suggest that an open surgical approach consisting of a combination of bursectomy, resection of the calcaneal deformity, and topical administration of PRP membranes may be effective for the treatment of Haglund's disease.

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