Best Los Angeles Ankle Surgeons use Stem Cell Treatment for Ankle Arthritis

Osteoarthritis is the most common joint disease and affects more than 20 million people in the United States alone. Osteoarthritis is characterized by progressive cartilage degeneration with functional loss of motion at a joint. Although osteoarthritis can affect any joint, it most often will affect the weightbearing joints such as the knee, hip, foot, ankle, and spine. There are many contributing factors that may cause osteoarthritis, but it is most commonly caused by abnormal mechanics or loads on a joint, a mal-alignment of a joint, a previous infection in the joint, or a previous trauma to a joint.

Traditionally, osteoarthritis is treated with physical therapy, steroid injections into the joint, oral use of anti-inflammatory medication, lubrication injections, and life-style changes. For the ankle, the use of a brace may help stabilize the joint and prevent painful motion at the ankle. There are some surgical options that may help alleviate ankle pain from ankle arthritis, including ankle arthroscopy, joint distraction, cartilage replacement surgery, and spur removal. Should those preliminary procedures fail to give relief and the arthritis progresses, the end-stage treatment for osteoarthritis of the ankle is either ankle fusion or ankle replacement.

Stem Cell Treatment for Ankle Arthritis

Although ankle fusion or ankle joint replacement surgery for ankle arthritis is generally very successful, it does come with risk factors and a long recovery period. Recently, there have been advances in the use of stem cells to treat osteoarthritis in the area of cartilage repair as a minimally invasive procedure without the need for a major open reconstructive ankle surgery. In addition, there is a very minimal chance of rejection as the cells are harvested from the patient’s own body; usually from bone marrow or fat. Stem cells have the potential to develop into different cell types, including cartilage cells. In addition, they have properties which enhance the body’s repair mechanisms such as reducing inflammation, increasing healing potential, and reducing scarring.

The benefits of using stem cells to repair cartilage in arthritic joints are many and there seem to be minimal complications with their use. Additional research is needed in the area of stem cells for use in arthritic joints in humans, but preliminary studies in humans and rat models show promising results, and we may be approaching a cure for arthritis.

Platelet Rich Plasma for Plantar Fasciitis and Heel Pain Treatment

Plantar fasciitis is a very common condition of the heel. It is the most common diagnosed cause of heel pain. It will affect about 1 million people each year. Beverly Hills Foot Surgeon, Dr. Soomekh, has been using platelet-rich-plasma (PRP) therapy as a means of heel pain treatment for chronic plantar fasciitis for the last 3 years. His results have been increasingly promising with regards to decreased pain, increased activity, improved function, faster recovery, and increased strength. The use of PRP in the clinical setting is advantageous for its ease of use, relative availability, lack side effects, and tolerability, as compared to more invasive techniques.

Dr. Soomekh performs the procedure in the office under local anesthesia using ultrasound guidance.

Platelets are basic cells in our bodies that produce special proteins called growth factors. These growth factors are responsible for healing damage to tissues and wounds and clotting. When there is an injury to part of the body the platelets will rush to the area of injury to begin the healing process. This is part of what is called inflammation. This is true for a new or what is called acute injury. In cases of long standing injury or chronic injury, there is less inflammation and a low concentration of platelets around the site of injury. In effect, the injury is not being aided by healing factors because it is now an old injury.

The idea behind injections of platelet-rich-plasma is to purposefully introduce an increased concentration of the patient’s own platelets into the site of injury. Once there are more platelets around the area, there are then more healing factors in the area, creating an environment that can promote healing. Additionally, the simple act of the needle being introduced several times into the site of injury will stimulate and injure the tissue. The body will think this area is now a new injury. Effectively we are taking and old chronic injury and changing it to a new acute injury, while at the same time introducing even more platelets.

The process of acquiring the platelets is simple. Blood is drawn from the patient’s arm, in the same way one gives blood at the family doctor’s office. The patient’s blood is then spun down in a centrifuge in order to separate the platelets from the rest of the cells in the blood. The high concentration of platelets is now collected in a syringe ready to be injected into the site of injury.

Those patients that have failed conservative therapies are good candidates for platelet-rich-plasma injections. Platelet-rich-plasma as proven to be an extremely effective none surgical form of heel pain treatment.

These injections are a midway approach to help heal chronic plantar fasciitis between conservative care and surgery.

For more information see a published article by Dr. Soomekh at http://www.podiatrytoday.com/platelet-rich-plasma-can-it-have-impact-plantar-fasciitis

Dr. Soomekh is available for consultation at Santa Monica and Beverly Hills locations of the University Foot and Ankle Institute. For an appointment, please call University Foot and Ankle Institute toll free at:

877-677-0011

University Foot and Ankle Insitute and The Los Angeles Ballet:  A Perfect Combination

University Foot and Ankle Institute is proud to have been selected by the Los Angeles Ballet Company as the official foot and ankle care center.  After years of care for ballet and other dancers, University Foot and Ankle Institute was approached to provide state of the art care for the amazing professional ballet dancers who are part of the Los Angeles Ballet Company.

“We are very proud of this affiliation and feel it allows us to treat these amazing dancers with very high tech. options and offer them the most rapid recovery and the longest sustained careers” noted Dr. David Soomekh, a foot and ankle surgeon at University Foot and Ankle Insitute.  Dr. Soomekh has assumed the primary role of caring for the ballet company but is aided by the entire foot and ankle and physical therapy staff at University Foot and Ankle Insitute.

“This is an amazing opportunity for our practice to show how we can care for these elite athletes and also to learn from them how to get patients rehabilitated and back to their profession as rapidly and safely as possible” noted Dr. Bob Baravarian, co-director of University Foot and Ankle Institute.

University Foot and Ankle Institute has been at the forefront of comprehensive foot and ankle care since its inception.  The team of doctors and physical therapists care for all types of foot and ankle problems and all age patients with emphasis on compassionate and efficient care.  From the most simple to the most complex foot and ankle ailment, no problem is to small or to large to handle.

For an appointment with one of our doctors at one of our 11 Southern California locations please call 877-677-0011 or visit www.footankleinstitute.com

Big Toe Pain: Sesamoid Pathology

The sesamoids are two small round or oval bones situated in the thick soft tissue ligamentous plantar plate under the first metatarsaophalangeal (big toe) joint (Figure 1) and provide attachments for multiple important ligaments and muscle-tendinous units that provide critical stability, strength, and function to the big toe during ambulation and propulsion. They fully ossify by the age of 7. They usually ossify by multiple centers of ossification and rarely this bone can develop an incomplete fusion and bipartide sesamoids have been reported from 7-30% of the time and usually involve the tibial (medial and larger of the two bones) and are usually found to be bilateral. They are infrequently symptomatic however, their tortuous circulation make them prone to slow healing and potential for avascular necrosis when injured.

FIGURE 1 Normal Sesamoids

Type of Sesamoid Injuries

 

Extracorporeal Shock Wave Therapy For Plantar Fasciitis and Achilles Tendonitis

Extracorporeal Shock Wave Therapy or ESWT, was initially used in the treatment of urinary, kidney, and salivary stones.  ESWT has been used since the late 1980s for the treatment of various musculoskeletal disorders, including:

-  plantar fasciosis/ plantar fasciitis

-  Achilles tendinosis/ Achilles tendonitis

-  sesamoiditis

-  stress fractures

-  fresh fractures of bones

-  delayed union of fractures

-  nonunion of fractures

-  wound healing

Currently, we use the treatment for mainly plantar fascitis/fasciosis and for Achilles tendonitis/tendinosis conditions.  Although we have used it for would healing, we have found better options for these other conditions.

 ESWT is not limited to the foot and ankle problems, as it has also been shown to help:

-  patellar tendinopathy (jumper’s knee)

-  lateral epicondylitis (tennis elbow)

-  medial epicondylitis (golfer’s elbow)

-  shoulder calcific tendinitis

Types of ESWT

ESWT has been FDA approved and used in the United States since 2000.  ESWT is a non-invas ive treatment that involves the delivery of low- or high-energy shock waves to a specific site to the body.  Low-energy shock waves require a series of treatments and do not typically require anesthesia or injections.  High-energy shock wave treatment is done in one session and usually requires general or regional anesthesia.  Currently, more physicians are using low-energy shock waves without any anesthesia.  A recent 86 patient study by Rompe et al. showed that using local anesthesia before shock wave treatments actually reduced the efficacy of ESWT.  In another recent study by Klonschinski et al., local anesthetic was found to inhibit and alter the effects of ESWT.

We have used both low energy and high energy shockwave therapy options.  With high energy, due to the need to get a good treatment with one shockwave session and the overall cost of multiple sessions, we have found that in certain cases there is an over treatment which may result in stress reactions or bruising of the heel.  Furthermore, the treatment is very aggressive and may be overkill.  On the contrary, stress fracture or delayed bone healing cases seem to do better with high energy treatment.

Low energy cases seem to be a little less stressful to the foot and do not cause deep bone bruising.  Low energy shockwave does require 3 treatments on average, however the treatments can be more catered to the patient’s needs and symptoms.

Mechanism of ESWT

ESWT is thought to work on areas where the body has stopped responding to the area of concern due to the chronicity of the problem.  Multiple studies have shown that over time, there is a reduction in the amount of blood flow to a region of damage.  This blood flow is essential for healing of damaged tissue.  Without blood flow, there is an increase in chronic scar tissue resulting in chronic pain.  ESWT increases trauma to the area causing the return of blood supply which helps with healing.  The shock waves travel through fluid and soft tissue and their effect occurs at sites where there is a change in impedance (ie -bone/soft tissue interface).  This creates an expansion and compression within the area being treated.  The expansion and compression of the soft tissue causes microscopic levels of trauma to the area of concern, stimulating inflammation to the area, thereby promoting blood flow and nutrients to reach the problem area and stimulate healing of the area.  It is also thought that ESWT may reduce the transmission of pain signals from the sensory nerves, reducing sensitivity and pain to the foot.  It is important that no anti-inflammatory medications are taken after ESWT as it would counteract its purpose.

When do we consider shockwave?

ESWT is considered when patients fail approximately 6 months of conservative therapy.    At this point, musculoskeletal problems are generally chronic and require acute inflammatory tissue to resolve the issue.  Conservative therapy for musculoskeletal problems often involve:

-  icing

-  rest

-  physical therapy

-  custom or over-the counter orthotics

-  activity modification

-  shoe modification

What is the visit like?

Low-energy ESWT is performed in the office over a period of 3 visits, each spaced about one week apart.  Thousands of shock waves are directed at the area of concern without local anesthesia and are custom catered to the patient’s needs.  Patients will typically feel mild improvement after the visit, significant improvement after the second treatment and often

 are able to return to work and activities of daily life after the third treatment.  Patients may be put in a walking boot for comfort or kept in a stiff soled shoe.  Some patients may experience bruising, reddening, or swelling of the treated area.  The patient should refrain from taking any anti-inflammatory medication so that the effects of the shock wave can be realized without inhibition.  Overall, shockwave is a very safe treatment option but there are a few contraindications to shockwave, including bleeding disorders, and pregnancy.

Conclusions

ESWT is similar to treatments such as Platelet-Rich-Plasma, and Topaz ablation therapy in that they turn a chronic, or non-inflammatory, process into an acute, or inflammatory, process, leading to increased blood flow and healing to the area.  However, ESWT is the least invasive of the three as it can be done in the office and does not require any needles or opening of the skin.  ESWT is becoming one of the mainstays of treatment for many chronic musculoskeletal problems as there is an increasing body of evidence supporting the use of ESWT for various musculoskeletal areas of the body.

Radio Frequency Topaz Microdebrider for Chronic Heel Pain

Heel pain is a common presenting complaint causing patients to seek a foot and ankle surgeon or doctor.  One of the most common etiologies of heel pain is mechanical or repetitive overuse injury causing inflammation of the plantar fascia, termed Plantar Fasciitis.

Symptoms of Plantar Fasciitis

•  Pain and stiffness in heel (can be worse in morning)
•  Inability to walk long distances
•  Swelling around heel

Causes and Risk factors of Plantar Fasciitis

•  Repetitive loading or exercise
•  Change in activity level, duration, or training surfaces
•  Recent activity/long walking in unsupportive shoes or sandals
•  Abnormal foot mechanics and architecture
•  Recent weight gain or obesity
•  Acute trauma or injury 

Conservative treatment options for Plantar fasciitis

•  Icing
•  Stretching of the Achilles tendon and plantar fascia complexes
•  Rest or activity modifications
•  Custom orthotics or over-the-counter orthotics
•  Supportive and comfortable shoes
•  Oral anti-inflammatories
•  Physical therapy modalities
•  Heel injections
•  Night splints

Plantar fasciitis generally resolves with conservative management, however certain cases even fail 6 months of conservative treatment and may require surgical procedures to help alleviate the symptoms.  Podiatry Research has demonstrated that chronic injury and inflammation to the plantar fascia leads to micro-tears and degeneration of the plantar fascia, termed plantar fasciosis.  Plantar fasciosis lacks acute inflammatory tissue, accordingly, rendering conservative options unsuccessful at times.

Surgical options for Recalcitrant Plantar Fasciitis and Plantar Fasciosis

• Topaz (ArthroCare) Microdebrider
• Platelet Rich Plasma injection
• Shockwave therapy
• Open and Endoscpoic Realease

Topaz Coblation Microdebrider procedure is a minimally invasive surgical technique utilizing small holes to break up the scar tissue and attempt revascularization of the plantar fascia.  By “burning holes” into the ligament, the Topaz will turn a chronic process into an acute inflammatory process to cause an influx of inflammatory healing cells directly into the ligament.

The procedure is performed in the operating room.  The anesthesia team will administer sedation medications and then a local nerve block is performed by the foot surgeon. The surgeon will then mark  the area of the plantar fascia and make holes in the skin.  The topaz probe is then placed through these holes into the plantar fascia. The patient is then placed into a walking boot for a period of 2 to 3 weeks during the healing process.

The procedure only requires small holes compared to a larger open incision and surgery.  This lends to quicker healing and less pain and scar tissue and faster recovery. 

Click below to watch a video of the Topaz heel pain treament procedure.

Video: Topaz Procedure for Chronic Plantar Fasciitis Heel Pain

Think the Topaz procedure might help you? For help with your heel pain, contact UFAI, California’s leaders in foot and ankle care. To an appointment please Call 877-501-0193 or Request a Heel Pain Consultation online.

Bellflower and Cypress Podiatry Offices of University Foot and Ankle Insitute Welcome Dr. Doron Nazarian to the Group.

This month’s spotlight is on California Podiatric foot and ankle surgeon Dr. Doron Nazarian. After completing a comprehensive foot and ankle residency program at Olympia Medical Center in Los Angeles, Dr. Nazarian completed a comprehensive sports medicine and reconstructive surgery fellowship at University Foot and Ankle Institute.

Bellflower, CA and Cypress, CA Podiatry Locations

Dr. Nazarian can be found at the UFAI Bellflower and Cypress locations serving the residents of Bellflower, Cypress, and also Los-Alamitos, Long beach, Seal beach, La Palma and other regions of north Orange County. The practices are located in the heart of orange county with freeway access from the 91, 405, as well as the 605 freeways. University Foot and Ankle Institute offers the latests technology and surgical expertises in the podiatric medicine, surgery and biomechanics arenas.

Dr. Nazarian concentrates his efforts on common as well as reconstructive foot and ankle pathologies including corrective bunion surgery, pediatric and adult flat feet deformity, sport related injuries and biomechanical abnormalities. Dr. Nazarian is available for consultation at the bellflower and cypress offices. For an appointment, please call 877-677-0011.

What is a Bunion?

Bunionscome in all shapes and sizes.  They are largely genetic resulting from a looseness of the great to and midfoot joints resulting in a shift of the bone and bunion formation.  Although genetics are the primary cause, shoes and other factors can accelerate and worsen bunion problems.

Conservative management:

• Well-fitting, supportive shoes
• Custom functional orthotics, stabilizing the medial column of the foot and slowing down the progression of the bunion deformity.
• Bunion night splints
• Padding over the prominent bone
• Toe alignment splints
• Injections and pills don’t play much of a role in managing a painful bunion.

Conservative management of bunion problems are exactly that:  management.  It is not typically curative or designed to fix the problem.  At some point, surgery is recommended.  Surgery is usually recommended when the deromity becomes painful, affects shoe choice, and when the discomfort limits activities.  Surgery is discouraged if there is no pain, and when cosmesis is the main driving force.

Bunion Surgery Work-up:

Because bunions come in all shapes and sizes, the surgical treatment must include a varied approach.

The choice of bunion surgery depends on:

-    The size of the bunion deformity

-    The laxity of the bone and how loose the foot bones are

-    The angle of the cartilage of the great toe

-    Deformity of the great toe bones and/or bunion only

-    The length of the metatarsal bone leading to the great toe

Surgical bunion treatment:

• Simple bumpectomy

  • This is the simple, minimalist approach.  This is the wrong surgery for most people, but can be effective when chosen wisely.  Easy recovery with this procedure.  Usually not great long term correction, how ever.

  . Classic Chevron type osteotomy

• This is the most common procedure done to correct bunion deformities.  It includes shaving the prominent bump, but also includes a shift and realignment of the head of the metatarsal and the big toe joint.  This is fixated with pins or screws; our choice at UFAI is usually a 2-screw fixation, which is very stable and allows for earlier weight bearing and range of motion.  We usually allow weight bearing protected in a walking boot right away after this surgery.

• Reverdin type osteotomy

  • This procedure can correct some angular problems in the region of the deformity, having it’s strongest correction on the joint position/alignment.

• Akin phalangeal osteotomy

  • When there is alignment problems within the toe itself and it is angulated strongly toward the 2^nd toe, this procedure removes a wedge near the base of the toe that swings the toe into a straightened position.

• Base wedge osteotomies

  • Though these procedures are considered somewhat unstable, they can be good to correct higher angled bunion deformities.  When these are done with wedge bone grafting and screw or plate fixation, they can provide solid correction, still maintain good metatarsal length, and can be relatively stable.  Recovery includes a period on crutches, usually about 4-6 weeks.

• Lapidus procedure (wedge corrective fusion of the 1^stmetatarsal cuneiform joint)

  • This procedure gets to the root of many bunion pr oblems.  By correcting and stabilizing this joint at the base, strong correction can be achieved.  This usually affords excellent long term correction.  This is usually the procedure of choice for younger people with a hypermobile midfoot joint.  This requires cast and crutches for 4-6 weeks or so after surgery.

The University Foot & Ankle Advantage:

Bunion Surgery has become more refined over the years.  At the University Foot & Ankle Institute, we custom-design the bunion surgical procedure and experience for the individual.  Every foot and circumstance can be unique an no one procedure is well suited to all foot types.  At University Foot and Ankle Institute, we are flexible in using the appropriate combination of procedures to achieve quick recoveries as well as the best long-term outcome.

Achilles Tendon Problems? Treatment Options are Available!

The Achilles tendon is the largest and strongest tendon in the human body.  It is crucial in transmitting forces responsible for walking, running and various other activities.  An injury or tear within the Achilles tendon can cause substantial pain and limitation due to its importance in these daily activities.  

Anatomy:

The Achilles tendon is made up of the tendons of the gastrocnemius muscle and soleus muscle, which make up the largest muscles within the calf.  It inserts at the back of the calcaneus (heel bone) and many of the tendon fibers can extend further underneath the heel.  Tears of the Achilles tendon can be partial tears, which only involve a portion of the tendon or complete tears.   Most often a tear occurs in the mid-portion of the tendon, often referred to as the “water shed” area due to its limited blood supply.   It is the limited blood supply that can make Achilles tendon tears challenging and can take an extended length of time to heal.

Etiology:

Tears of the tendon are often a result of indirect trauma.  Overload forces exceed the tensile strength of the tendon which results in tearing of the tendon fibers.  Complete ruptures most often occur in individuals between 30 and 45 years of age with the majority of injuries sustained during sporting activities.  Tendon tears are can also in patients with systemic diseases such as rheumatoid arthritis, lupus, chronic hemodialysis and many others.  Other factors correlated with potential Achilles tendon tears are steroid use, fluoroquinolone antibiotics and previous injury to the tendon.

Symptoms of Torn Achilles Tendon:

• Pain                                         
• Swelling    
• Bruising
• Loss of strength     
• Palpable gap in tendon         

Diagnosis:

The most crucial step to diagnosis of Achilles tendon tears is a thorough and detailed physical examination.   Patients may not experience complete loss of strength in many instances.  Because of this and the swelling in the area, up to 20% may be missed on initial presentation.  A delay in treatment can have long lasting effects on the overall outcome and thus emphasizes the importance of being evaluated by a foot and ankle physician in a timely manner. 

Radiographs may be taken to rule out other associated injuries.  To fully evaluate the extent of Achilles tendon injury, an ultrasound, or more often, an MRI will be performed.   This allows the physician to visualize the extent of tendon injury and determine the best treatment plan.

Treatment:

Treatment will vary depending on the extent of tendon tear, duration the tear has been present, and the patient.  An acute, complete rupture of the tendon requires surgical intervention.  This is typically done by re-approximating the torn ends of the tendon to allow for appropriate healing.  For the best function results, the repair should occur within one week in order to avoid retraction of the tendon ends.  Unless the patient is relatively sedentary, cast immobilization as the primary treatment of an Achilles tendon rupture should be avoided due to the increased risk of re-rupture, decreased strength and sub-optimal functional results.

Achilles tendon tears that are not treated for longer than 4 weeks are considered chronic.  Because of the delay in treatment, the tendon ends are become retracted and cannot be repair like an acute rupture.   Chronic Achilles tendon ruptures are typically repaired surgically and involve more extensive tendon transfers, flaps or grafts.  After surgical intervention, patients are immobilized in a cast for 2-3 weeks, followed by a transition to a walking boot.    It is essential to try to begin strengthening of the tendon as quickly as possible to avoid weakening.  This needs to be done carefully by trained physical therapist who understand the recovery protocol of Achilles ruptures. 

The University Foot and Ankle Institute Advantage

At University Foot and Ankle Institute, we understand the complete function and necessary recovery needs of Achilles tendon ruptures.  We pride ourselves in performing state of the art surgery for Achilles tears and we also have added several new designs to the surgical repair procedure to improve and speed up recovery including stem cell grafting and soft tissue augmentation procedures for added strength.  Finally, through our on site physical therapy services, we are able to provide rapid and tested recovery protocols to return you to full function in a timely and safe manner.

Advancement in Achilles Tendon Tear and Achilles Rupture Care

The Achilles tendon is the strongest tendon in the body but it is also the one that is most commonly injured.  In this article we discuss the anatomy of the Achilles tendon as well as give an overview on Achilles tendon ruptures.  

Achilles Tendon Anatomy 

The Achilles tendon is approximately 15 cm in length and is made up of a combination of fibers that are derived from two calf muscles which twist 90^o and insert at the back of the calcaneus or heel bone.  The Achilles tendon gets its blood supply from 3 sources.  There is an area on the Achilles tendon approximately 2 to 6 cm above its insertion to the calcaneus that has poor circulation and is called the watershed region.  Due to the diminished blood supply, this is a common area for Achilles tendon lesions and ruptures.  

Acute Achilles tendon ruptures

Achilles tendon ruptures occur most often in middle-aged men during athletic activities.  Patients with Achilles tendon ruptures often say that they felt a sudden pop or snap in their calf with subsequent weakness or difficulty with ambulation.  Some say they felt someone kicked them or hit them from behind but there is noone in the vicinity.  Patients may be able to walk with minor swelling and pain after a tear but have weakness.

Achilles Tendon Tear Exam

On examination, a palpable defect in the tendon can be felt and there is often an increase in upward movement of the ankle due to the lack of tension from the Achilles tendon.  A common test that is used to evaluate the integrity of the Achilles tendon is the Thompson calf-squeeze test.  Squeezing the calf muscles on the affected side will yield little to no movement in the ankle when compared to the unaffected side.

Imaging of Achilles Tendon Tears or Ruptures

MRI and ultrasound are often used to confirm the presence of an Achilles rupture and to evaluate the extent of the rupture.  The diagnosis of Achilles tendon ruptures, however, is based on clinical examination.  Imaging is often used for surgical planning or in cases in which there are equivocal examination findings.

Achilles Tendon Tear Surgical Advancements

Operative and nonoperative methods offered by foot and ankle doctors have shown favorable outcomes.  Generally with surgical repair, there have been reports that there is a decreased rate of re-rupturing the tendon, improved strength, improved ankle motion, better return to activities, and fewer complaints.  

Operative treatment involves reapproximating the two ends of the ruptured tendon together using special suture techniques.  A repair can be augmented with a tendon transfer, or synthetic graft.  Rarely, the Achilles tendon may rupture at its insertion into the calcaneus.  In these cases, a tendon anchor may be used to reattach the Achilles to the bone.  The patient is then put in a non-weightbearing cast for 4 to 6 weeks followed by gradual weight bearing and physical therapy.  

University Foot and Ankle Institute Achilles Tendon Tear Advancements

University Foot and Ankle Institute has performed extensive surgical research into the ideal treatment and rehabilitation of Achilles tendon tears and ruptures.  By using a very strong stitching material, often augmenting the tear with a tendon wrap, and getting a very strong repair of the tendon, rehabilitation and cast removed is done rapidly.  By not casting the patient for a long time, the Achilles does not lose as much strength and return to activity is quicker.  University Foot and Ankle Institute is proud to offer the latest advancements in the repair of Achilles tendon tears and Achilles ruptures.