University Foot and Ankle Institute is an internationally-recognized leading organization for the treatment of foot and ankle problems. Our team of foot and ankle specialists comprehensively treat all foot and ankle problems from simple achilles tendonitis, bunions, heel pain, plantar fasciitis, neuroma pain, ankle sprains and fractures to the most complex reconstructive surgery and limb salvage of the foot and ankle.
Achilles tendinosis develops in cases of neglected pain and swelling of the Achilles tendon. If the tendon is not cared for at an early period and chronic overload of the tendon continues, the tendon eventually begins to get microscopic tears that develop into scar tissue. This results in enlargement of the tendon and scar tissue in the tendon which causes pain.
If caught early, conservative measures such as physical therapy and orthotic custom insoles may be used to reverse the scar tissue and pain.
Conservative treatment can be attempted when there is tendinosis, with less probability of healing due to the chronic nature of the deformity. Immobilization and physical therapy may be attempted.
In certain cases of chronic pain and swelling, a novel approach called Platelet Rich Plasma Injection can be used to allow for healing of the tendon. In Platelet Rich Plasma Injections therapy, the patient's blood is collected and spun down taking out the rich healing plasma material. This plasma is then injected into the tendon and begins a healing cascade within the body that allows for removal of the poor scar tissue and healing of the tendon without the need for surgery.
University Foot and Ankle Institute is proud to be one of the first organizations in the world to be involved in this novel approach and has taught the technique to many surgeons all over the world.
The extra thickening of the tendon will need to be reduced. The scar tissue and any damaged tendon will need to be removed. With continued scar formation, Topaz coblation may be needed to break up the scar tissue and bring new blood to the area. This coblation will turn this chronic problem into a new acute problem that can heal in a controlled environment. The patient will be placed in a cast on crutches for a period of weeks. In rare cases, the tendon may need to be reinforced with another tendon by transferring a tendon to the achilles tendon..
Picture showing the Achilles tendon split opened in order to reduce the thickening and remove the scar tissue.
Topaz probe being used to fenestrate the Achilles tendon.
Notice the pinpoint holes within the substance of the tendon.
Final repair and closure of the tendon.
University Foot and Ankle Institute doctors are innovators in the use of the Topaz procedure in the foot and ankle and also have a vast knowledge in the treatment of Achilles tendonitis and tendinosis issues.
With chronic micro-trauma to the Achilles tendon, there is formation of scar tissue and partial tears of the Achilles. This process continues on for months to years resulting in a thickened, damaged and scarred tendon which is enlarged and painful. In such a case, the tendon needs to be cleaned up and scar tissue needs to be removed surgically to allow the Achilles tendon to heal and function properly.
Picture showing the swelling and bulbous tendon above its attachment to the heel bone. Notice the point of the scissors pointing the area of thickening of the tendon.
Picture showing an achilles tendon. The foot is on the right going down and the leg is to the left. Notice the increased thickening of the tendon from scar tissue formation.
The Achilles tendon scar tissue and swollen area is debrided and the scar tissue is removed. The tendon is then protected to allow healing to occur and with post operative physical therapy, normal function can return.
University Foot and Ankle Institute is a world leader in the treatment of acute and chronic Achilles tendon problems. We offer state of the art treatment options both conservative and surgical to treat Achilles tendon ailments. Our Podiatrists and surgeons are the very best. Request an appointment with a doctor at our Los Angeles or other Southern California offices.