A prospective observational study on the functional outcome of retrocalcaneal bursitis following arthroscopic management

Introduction

Heel pain is a common foot and ankle complaint in the Orthopaedic OPD. Posterior heel pain occurs due to a handful of etiologies, more prominent of which is retrocalcaneal bursitis. Management of posterior heel pain in majority of the cases is non-operative. However, surgical intervention may be indicated if conservative therapies fail. This study aims at finding the functional outcome after arthroscopic management of retrocalcaneal bursitis.

Methodology

A total of 29 patients were recruited for the study after applying the selection criteria. Standard knee arthroscopy equipment and instruments were used with gravity assisted fluid system. After making medial and lateral portals, the inflamed bursa was debrided using a motorised shaver and an arthroscopic burr was used to resect the calcaneal prominence. A post-operative rehabilitation protocol was followed and the cases were followed up at regular intervals for a minimum of 12 months.

Results

After excluding losses to follow-up and post intervention exclusions, data of 23 patients were considered for statistical analysis. There was a consistent improvement in the variables of the AOFAS score at the follow up intervals. The total AOFAS score showed consistent improvement from a pre-operative mean score of 66.96 to a mean score of 88.44 at 03 months to maximal mean score of 96.00 at 6 months (p < 0.001). There were 02 minor complications in the form of hypoaesthesia in sural nerve distribution which were managed non-operatively. None of the cases required revision surgery.

Conclusion

Arthroscopic decompression is a feasible and efficient procedure for the treatment of retrocalcaneal disorders. The time to return to normal activity level is short. Sufficient exposure of the Achilles tendon and adequate removal of the calcaneal prominence and bursal tissue can be done effectively using an arthroscopic technique. It yields cosmetically better results with low incidence of complications.