by Paul Bishop, DPM, FACFAS
My partner, Thomas Rappette, DPM, FACFAS, and I are using radio frequency (RF) technology to enhance achilles tendon surgery at Rush-Copley. TOPAZ, developed by Arthrocare, Inc., uses very small pulses of RF energy to create areas of growth factor in the tendon, speeding healing of the tissues.
This type of surgery was used in heart, liver, esophageal and other procedures, but it has shown to be very helpful as an adjunct to good repair of tendon injuries. This technology can be used in many other tendons of the foot and lower leg to help healing.
Overuse can cause the Achilles tendon to tighten and pull so hard on the heel bone that a bone spur, or bump, develops. Shoes can rub against the spur and cause pain. In addition, a painful fluid-filled sac called a bursa can develop between the heel bone and the tendon. Traditionally, correcting this tightness involved severing the tendon, removing the bone spur or bursa, and then reattaching the tendon.
New less tendon destructive techniques can provide a less invasive option to removing bone spurs and bursas without significant damage to the Achilles tendon. When the tendon does have to be surgically detached, new bone anchoring instruments (devices placed into the heel bone to secure the tendon and tissues) can reattach the tendon, minimizing the chance of a potentially painful knot on the back of the heel.
Achilles tendon ruptures are the most serious Achilles injuries. Most patients require surgery to decrease the likelihood of a re-rupture and weakness of the tendon. Various techniques are available, and increasingly may include tissue grafts used as a bridge to link the severed tendon lengths. The graft provides a scaffold on which new tissue grows, increases the overall strength of the repair, and is usually absorbed by the body within a year.
A new type of synthetic material used in Achilles and other tendon repairs has excellent strength up to four years post injury. This helps maintain operative repair much longer.
Paul Bishop, DPM, FACFAS, is a foot and ankle surgeon with The Centers for Foot and Ankle Surgery with offices in Yorkville, Morris and Sandwich. To schedule an appointment, call 630-553-9300.