Minimally Invasive Achilles Tendon Tear Repair: why this is the best option.

Minimally invasive techniques in foot and ankle surgery have gained popularity over the years. Although many times an open incision system is best, in the case of Achilles tendon tears, the best option truly is a minimally invasive system. The purpose of this article is to give greater detail to why a minimally invasive technique is best in our eyes.

Causes and Symptoms of an Achilles Tendon Rupture

Achilles Tendon Rupture Minimally Invasive TreatmentThe Achilles tendon is the largest and strongest tendon in the body. A rupture of the tendon can occur with a sudden strain or stretch of the tendon resulting in a loud “pop” and pain in the back of the ankle/heel. Patients will often note the feeling of being kicked or hit in the back of the leg.

After a short period of time, ranging from a few hours to a few days, the pain can resolve as the tendon is completely torn and does not assume any further strain. This makes some patients feel that they did not injure themselves. What is often noted, however, is a feeling of weakness with push off and difficulty with single heel raise.

Treatment for a Ruptures Achilles Tendon

Repair of the Achilles tendon rupture is critical for proper function of the foot and ankle.

It is rare not to repair a tear and the only cases of conservative care are often in poor surgical candidates and patients who have a sedentary lifestyle. In order to return to full activity, a repair of the tendon is essential.

For years, the Achilles tendon has been repaired through a large open incision. This technique requires full exposure of the tendon and opening of the sheath around the tendon that prevents scar formation. Furthermore, the repair is done in the damaged area of the tendon, which is the weakest and most problematic region.

Minimally Invasive Achilles Tendon Repair

A percutaneus minimally invasive repair is done through a one-centimeter incision. The stitches are placed in the strong and healthy area of the tendon through the use of a special stitch passing system. This allows grabbing of the healthy tendon and brings the tendon together in a stronger and more stable fashion. The split ends of the tendon are then sutured together with small stitches locally in the one-centimeter area for optimized repair.

 

UFAI Achilles rupture patient demonstrates Achilles tendon strength just 3 months after the PARS procedure.

Through the use of a one-centimeter minimally invasive incision, we are able to avoid exposure of the tendon which decreases scar formation and wound healing issues. We are also able to repair the tendon in the healthy region and not in the torn region by passing the stitches through the healthy tendon ends and then bringing the tendon together. This allows a more rapid recovery, earlier physical therapy and a quicker return to activity.

The percutaneous Achilles tendon repair system is the ideal manner to repair an acute Achilles tendon tear. It allows a very strong repair, limits exposure of the tendon, limits wound healing issues and scar tissue, allows a quicker return to physical therapy and a more rapid return to full activity. In very rare cases, the incision may need to be lengthened due to severe damage to the tendon or severe retraction of the tendon ends and this process is possible without issue if the procedure needs to go from minimally invasive to open.

Our recovery process has resulted in weight bearing and physical therapy often at 4 weeks and return to sports activity at about 3 months. This is approximately 3 months earlier than an open technique and significant in improvement. Furthermore, our rate of complications has been less than 1% with the minimally invasive technique and we are proud to note that 97% of our patients have returned to their previous level of activity with no long-term complications.

For more information about Achilles tendon treatment options or to schedule a consultation we encourage you to call at (877) 736-6001 or visit us at www.footankleinstitute.com.

Dr. Bob Baravarian, DPM, FACFAS

Dr. Bob Baravarian, DPM, FACFAS

Dr. Bob Baravarian is a Board Certified Podiatric Foot and Ankle Specialist. He is currently a member of UCLA Medical Group, Chief of Podiatric Surgery at Santa Monica/UCLA medical center and Orthopedic Hospital and an assistant clinical professor at the UCLA School of Medicine. He also serves as co-director of University Foot and Ankle Institute. He is Editor Emeritus of the international medical journal, Foot and Ankle Specialist.

Dr. Baravarian been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy and trauma/reconstructive surgery of the foot and ankle. He servers as a consultant to the ATP (Association of Tennis Professionals) tour, multiple running organizations and several shoe manufacturers. He is also fluent in five languages (English, French, Spanish, Farsi and Hebrew),

Podiatrist Dr. Bob Baravarian is available for consultation at the Santa Monica, Sherman Oaks and UCLA Westwood offices.
Dr. Bob Baravarian, DPM, FACFAS

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