HOME||ABOUT US||STAFF||APPOINTMENTS||INSURANCE||DIRECTIONS||CONTACT

Diagram of percutaneous repair procedure



Achilles Tendon


Percutaneous Repair




RELEVANT LINKS
:
Achilles Tendon LInks Page
Achilles Open Repair using Allograft
Achilles Tendon Repair Rehabilitation



Surgical Technique

To surgically repair the Achilles tendon, we anesthetize the area with a local anesthetic and sedate the patient with intravenous medication.  The proximal portion of the tendon, as identified by palpation and MRI, is captured with a #1 Tevdek suture placed transversely through the skin and the tendon and out the opposite side.  This suture is then crisscrossed through the tendon, the gap at the rupture site, and finally through the distal portion of the tendon just above the calcaneus (heel bone), through the skin punctures.

A second stitch is placed after the first one and is tied with the foot in plantar flexion.

A dressing is applied and the foot is placed in a plantar flexed pre-formed padded splint.
 


The Benefits & Risks of Percutaneous Repair

Benefits:

•     A full incision is not made, reducing the chance of infection or scar formation.
•     The tendon sheath holding the blood clot that forms at the time of the tendon rupture
      is kept intact, permitting rapid healing of the tendon.
•     No general anesthetic is required.
•     The rehabilitation program is accelerated.
•     Full return to sports is expected (pool at six weeks, golf three months, bicycling
      three months, tennis six months).

Risks:

•    Transient (temporary) numbness over the lateral border of the foot, if one of the
     sensory nerves gets caught by one of the sutures. This has always resolved
•    Irritation from one of the suture knots
•    There have been no infections or re-ruptures in our experience since we started
     using this technique in 1992.  We have not opened a single Achilles tendon rupture
     since 1992

(Image above taken from Bradley et al. Amer J Sports Med 1990 18:2 188)


 
3727 Buchanan Street, San Francisco, CA 94123 tel: 415-563-3110 Contact the Stone Clinic