{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T02:47:31Z","timestamp":1792896451465,"version":"4.5.0"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T00:00:00Z","timestamp":1744416000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The purpose of this study was to investigate the relationship between radiographic characteristics of retrocalcaneal enthesophytes in insertional Achilles tendinopathy (IAT) and likelihood of failing nonoperative management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A retrospective cohort study of 200 patients diagnosed IAT with symptomatic enthesophytes were identified and separated into operative and nonoperative cohorts. All patients had lateral weight-bearing radiographs which were used to measure the calcaneal spur-to-skin distance (CSK), calcaneal spur width (CSW), calcaneal spur height (CSH), and the Fowler-Philip angle (FPA). Demographic and radiographic parameters were compared between both groups. Multivariate regression analysis was performed to identify independent risk factors associated with failing nonoperative management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The operative group had significantly smaller CSK (6.0 mm vs 6.6 mm; P = .02), larger CSW (7.9 mm vs 6.2 mm; P &lt; .001), and larger CSH (14.1 mm vs 11.1 mm; P &lt; .001) compared with the nonoperative group. There was no significant between-group difference in FPA (61.9\u00b0 nonoperative vs 63.3\u00b0 operative; P = .052). Multivariate logistic regression analysis demonstrated CSK, CSW, and CSH as independent risk factors for failing nonoperative management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Radiographic measurements of retrocalcaneal enthesophytes are a simple and reliable method for predicting which patients have a higher likelihood of failing nonoperative management of IAT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>\n              <jats:italic>III, retrospective cohort study<\/jats:italic>\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1177\/19386400251331642","type":"journal-article","created":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T11:26:26Z","timestamp":1744457186000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Retrocalcaneal Enthesophytes and Radiographic Predictors of Failing Nonoperative Management in Insertional Achilles Tendinopathy: A Retrospective Cohort Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6655-5581","authenticated-orcid":false,"given":"Joseph A. S.","family":"McCahon","sequence":"first","affiliation":[{"name":"Jefferson Health, Stratford, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Kohring","sequence":"additional","affiliation":[{"name":"Jefferson Health, Stratford, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Schultz","sequence":"additional","affiliation":[{"name":"Jefferson Health, Stratford, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Massaglia","sequence":"additional","affiliation":[{"name":"Jefferson Health, Stratford, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrison A.","family":"Patrizio","sequence":"additional","affiliation":[{"name":"Rowan-Virtua School of Osteopathic Medicine, Rowan University, Stratford, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selene G.","family":"Parekh","sequence":"additional","affiliation":[{"name":"Rothman Orthopaedic Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David I.","family":"Pedowitz","sequence":"additional","affiliation":[{"name":"Rothman Orthopaedic Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph N.","family":"Daniel","sequence":"additional","affiliation":[{"name":"Rothman Orthopaedic Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,12]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-21-00679"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.56.2.85"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200003)43:3<576::AID-ANR14>3.0.CO;2-A"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-021-02370-0"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/6315846"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2021.07.010"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070002100802"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2023.02.018"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2018.08.021"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717723127"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-356-19"},{"key":"e_1_3_2_13_2","doi-asserted-by":"crossref","unstructured":"Fiamengo SA Warren RF Marshall JL Vigorita VT Hersh A. Posterior heel pain associated with a calcaneal step and Achilles tendon calcification. Clin Orthop Relat Res. 1982(167):203-211. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/7094464. 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