Percutaneous Achilles Repair System (PARS)

Updated 2/8/2024
UFAI Achilles rupture patient demonstrates Achilles tendon strength just 3 months after the PARS procedure.

The Achilles, a thick tendon in the back of your ankle, connects the calf muscles to your heel bone. Often medically referred to as the calcaneal tendon, the Achilles is essential for running, walking, jumping, and any form of movement in which you must push off from the ground. 

 

An Achilles tendon injury can greatly impair movement, and the most severe injuries, such as a torn tendon, can necessitate surgery.

 

If non-surgical treatment is not an option, and you require Achilles tendon surgery, you may want to consider the PARS procedure.

What is the PARS procedure for Achilles rupture repair?

Dr. Baravarian discusses Achilles tendon ruptures and the minimally invasive techniques available at UFAI.

PARS (percutaneous Achilles repair system) is a revolutionary minimally invasive treatment for ruptured Achilles tendon repair. 

 

In traditional Achilles tendon surgical repair procedures, such as open surgery, an incision will be made along the back of the calf. An orthopedic surgeon can then remove damaged portions of the torn calcaneal tendon, if necessary, and stitch the tendon back together.

 

However, the PARS Achilles tendon operation heals faster thanks to its smaller incision. Through a conservative opening, our orthopedic surgeons attach four high-strength sutures to the ends of the severed tendon. They are then pulled into an hourglass shape, fostering a tighter bond of the tendons that can aid healing. The end result is much stronger than previous repair techniques and leaves our patients with essentially no scarring.

 

What are the benefits of the PARS procedure?

To better understand the advantages of PARS surgery, it’s important to note that during a rupture of the Achilles tendon, the tendon doesn’t rupture cleanly; its fibers shred like frayed rope. 

 

Tendinopathy, a gradual breakdown of the tendon caused by overuse, can also result in a fraying of the tendon fibers.

 

How does PARS compare to traditional "open repair" surgery?

In traditional tendon repair surgeries, the “open repair” technique is used. The surgeon makes a 10-15cm vertical incision on the back of the ankle and pries open the skin to gain complete access to the Achilles. High-strength sutures are used either to hold both ends of a completely ruptured tendon together or to stitch the edges of a partial tear. 

 

Open surgery is often used for an acute Achilles tendon rupture, as it should be performed within two weeks of the injury. Unfortunately, healing time is lengthy, taking up to nine months. There is also a chance of re-rupture, especially if you return to your previous activity level too soon.

 

Immobilization via a cast is often required for six to eight weeks, which can result in tendon weakness, scar tissue formation, and a greater cosmetic impact.

 

UFAI PARS Yelp Patient Review, in her own words...

The following five star Yelp review was posted by University Foot and Ankle patient, Takashi.

5 Star Yelp review, University Foot and Ankle Institute

In March of 2017, I ruptured my left Achilles tendon while playing sports. My orthopedic surgeon at the time gave me basically only one option, open surgery.

 

I did some research and discovered there was another option, PARS (percutaneous Achilles repair system). This type of surgery was less invasive and the recovery time was much faster. My orthopedist did not offer this, he only offered open surgery. University Foot & Ankle was the name that always came up while researching PARS.

 

I scheduled an appointment and met with the doctor, who was warm and attentive from the first encounter. She gave me 2 options, nonoperative which requires months of casting or surgery with PARS technique. Of course, I opted for the PARS surgery technique.

 

During my whole experience, from office visits to surgery then follow-ups, the doctor and the office staff were incredible. I'm on my way back to normal now, and I owe it all to UFAI. Thank you so much.

 

Click here to see Takashi's review on Yelp.com.

 

Why choose the minimally invasive PARS surgery?

PARS Achilles Rupture Repair Scar Results
PARS procedure incision, 3 months post-op.

The benefits of the minimally invasive PARS technique allow for a very small incision, much less scarring, and a cleaner, speedier recovery. We make a 1 cm horizontal incision across the Achilles region, then slide the PARS repair guide into the healthy portion of Achilles away from the torn spot.

 

The PARS device allows the placement of sutures into the healthy tendon ends without the need for a large incision. The sutures allow for a greater area of compression and speedier wound healing.

 

What to expect during recovery for Achilles surgery

Torn Achilles healing time depends on the type of procedure you received. After PARS outpatient surgery, you’ll be placed in a walking boot for the first few weeks

 

You'll start a rehabilitation program around four weeks postoperation to prevent loss of range of motion and help you return to physical activity as soon as safely possible. Our recovery process often includes sports medicine-prescribed weight-bearing exercises and physical therapy. 

 

A return to sports activity can occur at about three months. This is approximately three months earlier than allowed after open repair surgery.

 

As for wound recovery, the tiny incision heals within a week and there’s minimal scarring. Additionally, the tendon itself heals with a thinner, more natural contour for a cosmetically appealing reconstruction.

 

Our rate of complications following Achilles heel surgery has been less than 1% with the minimally invasive PARS technique. We are proud to note that 97% of our patients have returned to their previous level of activity with no long-term complications.

 

Why UFAI is your best choice for Achilles tendon treatment

UFAI is nationally recognized for advanced treatment techniques, including the PARS procedure. Our orthopaedic team has decades of combined experience managing the special circumstances and concerns surrounding Achilles tear injuries and ruptures.

 

For a consultation, please call (877) 736-6001 or make an appointment online now.

 

University Foot and Ankle Institute is conveniently located throughout Southern California and the Los Angeles area. Our foot and ankle surgeons are available at locations in or near Santa Monica, Beverly Hills, West Los Angeles, Sherman Oaks, the San Fernando Valley, El Segundo, the South Bay, LAX, Calabasas, Agoura Hills, Westlake Village, Valencia, Santa Clarita, and Santa Barbara.

 

 

Achilles tendon rupture FAQ

Achilles tendon surgery FAQs 

 

How are Achilles tendon tears diagnosed? 

A physical examination using the Thompson test, which evaluates the integrity of your Achilles tendon, can inform the doctor if there are any Achilles tendon tears. An X-ray can confirm the diagnosis and show signs of tendinitis. Based on the findings, we may prescribe non-operative treatment or recommend surgery.

 

Can tendon surgery cause nerve damage?

Orthopedic surgery does have risks, even though they are usually minimal. Nerve pain or discomfort can be experienced after surgery because the sural nerve is usually close to the tendon. It’s important to report any discomfort to your healthcare provider at your follow-up appointment, as rest, physical therapy, and strength-building exercises can help prevent and combat Achilles tendon surgery nerve pain.

 

Can acute Achilles tendon rupture (ATR) cause a blood clot?

There is some association between acute Achilles tendon rupture (ATR) and deep vein thrombosis (DVT). Immobilization may cause issues with circulation and blood supply, making it essential that you visit your healthcare provider if you have any concerns before or after surgery.

 

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