Indicazioni all’utilizzo del concentrato midollare nella chirurgia endoscopica del morbo di Haglund
Abstract
AUTOLOGOUS BONE MARROW-DERIVED MESENCHYMAL STEM CELLS (MSCS) INDICATIONS FOR
ENDOSCOPIC TREATMENT OF HAGLUND’S SYNDROME
Surgical treatment in Haglund’s deformity involves removal of the dorsolateral part of the calcaneus up to the
insertion of the Achilles tendon and the inflamed retrocalcaneal bursa. Traditionally treated with open surgery, after
failure of the conservative treatment, there is increasing interest in a more minimally invasive approach to reduce
complications and improve the rate and ease of recovery. The poor results of open surgical treatment may be due to
incorrect indication for surgery, incomplete or aggressive bone resection, fibrosis, chronic tendinopathy, painful scars
and numbness in the heel. The minimally invasive surgical technique by an endoscopic calcaneoplasty (ECP) could be
an option to overcome some of these problems. The endoscopic technique include: patient prone, peripheral
anesthesia, standard instruments. We have used the autologous bone marrow-derived mesenchymal cells (MSCs)
obtained from iliac crest for severe Achilles tendonosis. The purpose of our study was to describe management of
Haglund’s Syndrome, evaluate the effectiveness of a minimally invasive procedure, demonstrating the validity as well
in the revisions of the open treatments in athletes. Adequate relief of symptoms is considered to be dependant on
removing any osseous irritation to the Achilles insertion (bone resection), fibrolysis and using autologous bone
marrow-derived Mesenchymal stem cells (MSCs) for severe Achilles tendonosis.
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© Società Italiana Ortopedici Traumatologi Ospedalieri d’Italia 2019 , 2019
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