The Achilles Tendon
Tendons are tissue that connect muscles to bones. The Achilles tendon, then, connects the muscles of the calf (the gastrocnemius and the soleus) to the heel bone (calcaneus).
The Achilles tendon is subject to a remarkable amount of stress, especially for recreational athletes. Any sport that involves jumping increases the risk of a torn Achilles, as does any sport that requires sudden stops and starts. That includes:
…and others. Certain other factors can weaken the Achilles tendon or make it more susceptible to rupture, such as:
- Age—being between the ages of 30 and 40
- Sex—being male
- Previous corticosteroid injections
- Antibiotics in the fluoroquinolone family, such as ciprofloxacin and levofloxacin
Achilles Tendon Rupture Repair
Research suggests that minimally invasive surgery can repair a torn Achilles tendon with less pain, a shorter hospital stay and faster recovery. In a traditional open surgery, the tendon is debrided first, which means stray tendon fibers are cleaned up. This creates two clean ends of the ruptured tendon for the surgeon to sew back together. With PARS, the surgeon is able to work around the stray tendon fibers and start the repairs from the healthy part of the tendon, which researchers think may promote faster healing.
Minimally-invasive surgery is not right for every patient, depending on the condition of the tendon and where the rupture is located. The surgery and rehabilitation can be adjusted depending on these factors. The minimally invasive technique has been used quite successfully in patients, and it is a very good consideration for repair of the Achilles tendon.
Once the diagnosis is made, patients have 2 treatment choices: non-surgical treatment or surgery. Non-surgical treatment can work well and is associated with fewer wound healing problems, but it does have the risk of higher rates of rupturing the tendon again and an increased recovery time.
Surgery can decrease the risk of rupturing the tendon again and is more likely to allow the tendon to again be the correct length. Having the tendon be the correct length is important so that you have the strength to walk normally once you are healed. However, surgery has two potential complications as well: slow wound healing and scar adhesions (when the skin sticks to the tendon).
Minimally-invasive Achilles tendon surgery can decrease the risks for both complications compared with traditional surgery. The surgery is performed through an inch-long incision (cut) where the tendon ends are located. A specially-designed stitch device is then passed up and around the tendon, which guides sutures (stitches) into the tendon and pulls them into the small incision. The sutures are then tied so the tendon ends meet, and when compared to the other leg, the foot and ankle should be in the same position. This means that the correct length of the tendon has been achieved.
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