Original article

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

Authors

• • Giuseppe Restuccia Giuseppe Restuccia ORCID profile. (opens in new tab)
  • Azienda Ospedaliera Universitaria Pisana, Pisa, Department of Orthopaedics, Italy
• • Giorgio Varchetta
  • University of Pisa, Pisa, Department of Orthopaedics and Trauma Surgery, Italy
• • Alessandro Lippi
  • Azienda Ospedaliera Universitaria Pisana, Pisa, Department of Orthopaedics, Italy
• • Lorenzo Dolfi
  • Azienda Ospedaliera Universitaria Pisana, Pisa, Department of Orthopaedics, Italy
• • Federico Bizzocchi
  • University of Pisa, Pisa, Department of Orthopaedics and Trauma Surgery, Italy
• • Stefano Giovannetti
  • University of Pisa, Pisa, Department of Orthopaedics and Trauma Surgery, Italy
• • Edoardo Ipponi
  • University of Pisa, Pisa, Department of Orthopaedics and Trauma Surgery, 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.

Keywords: Achilles tendon, AOFAS, Haglund’s syndrome, heel pain, PRP

How to Cite: Restuccia, G. , Varchetta, G. , Lippi, A. , Dolfi, L. , Bizzocchi, F. , Giovannetti, S. & Ipponi, E. (2023) “Platelet rich plasma (PRP) in the surgical treatment of Haglund’s syndrome: the use of PRP membranes as an intra-operative local adjuvant”, Medicinski glasnik. 21(1). doi: https://doi.org/10.17392/1651-23