Treating insertional Achilles tendinitis with bio inductive collagen scaffold - Does it improve outcomes? A case series.

Background: Achilles tendinopathy is a prevalent musculoskeletal condition, affecting approximately 6% of the population at some point in their lives. Insertional Achilles tendinopathy (IAT) is often associated with Haglund deformity (HD), and several surgical interventions exist to address this pathology. Bio-inductive Collagen Scaffolds (REGENETEN™ Smith & Nephew) is a novel bio-inductive scaffold that supports the body's intrinsic healing processes, promoting the growth of new tendon-like tissue. The application of Bio-inductive Collagen Scaffolds in the treatment of IAT and Haglund syndrome represents a relatively recent advancement. This study aims to present our experiences with the use of Bio-inductive Collagen Scaffolds (REGENETEN™) for treating IAT. Materials and methods: This investigation is a retrospective case series involving a single surgeon's experience with eight patients diagnosed with IAT and HD who underwent surgery utilizing Bio-inductive Collagen Scaffolds as an adjunct to standard treatment modalities between 2022 and 2023. The study was classified as a service evaluation by the local ethics committee. Data collected included age, comorbidities, complications, and AOFAS hindfoot scores pre-operatively and at six months postoperatively. Pre-operative and six-month postoperative MRI scans were similarly analysed. Results: The mean age of participants was 52.6 years (range: 43-65), with 50% of the cohort being female. The average follow-up duration was 10 months (range: 8-14 months). The AOFAS (Ankle-Hindfoot) score improved from 62.3 (range: 57-70) prior to surgery to 89.6 (range: 82-94) at six months post-surgery (p < 0.05). All MRI evaluations indicated complete healing by six months post-operation. All patients regained full preoperative function, averaging nine months after surgery (range: 6-11 months). No wound-related complications or other adverse events were noted during the follow-up period. Conclusions: The application of Bio-inductive Collagen Scaffolds appears to enhance patient outcomes without increasing complication rates. Future research is warranted to more comprehensively assess the benefits of Bio-inductive Collagen Scaffolds in the management of IAT and HD.