It doesn’t matter if you’re an NBA star, a competitive runner or a weekend warrior — rupturing your Achilles tendon is devastating. Not only is it a painful injury, but a full recovery can take several months and ruin your exercise regimen.
At the Big Ten track and field championships, I recently witnessed a runner rupture his Achilles tendon as he came off the curve in a 400-meter race. I heard the tell-tale popping sound that often accompanies a ruptured Achilles tendon and heard him describe the classic sensation of being kicked from behind at the time of the injury.
Unfortunately, it’s an injury I know all too well. As a former captain and four-year member of the track and cross country teams at Ohio State, I saw many athletes sustain injuries like this. Consequently, as a physician, I’ve made a concerted effort to find ways to treat tears of the Achilles tendon more effectively and heal them more reliably.
I’ve developed and have begun studying the results of a new technique to suture and repair torn Achilles tendons at The Ohio State University Wexner Medical Center. To this point, the results look very promising. By modifying a technique known as the “giftbox” method, I’ve used a single continuous loop of nonabsorbable suture to create a new way to restore the tendon’s length and tension. This technique may cut down on time to return to sports following surgery and strengthen the tendon long-term.
This modified “giftbox” technique uses the suture loop to weave nonabsorbable suture through the tendon and keep the knots away from the tear site, while also decreasing the risk of suture laceration. That approach is especially appealing because this technique has shown an improved suture pullout strength, particularly in severely damaged tissue. The idea is to use the suture to fortify the tendon after surgery and potentially help prevent future tendon re-tears.
The non-absorbable suture loop limits the number of times we puncture the native tendon in the process of bringing the two ends of torn tendon together, but also increases the number of suture strands that cross the tear site. We believe this approach will make the tendon stronger after surgery.
Lastly, we’ve moved the location of the suture knots that, literally, tie all these efforts together. In the past, most surgeons knotted their sutures at the tear site, but we’ve moved the knots away from the injury to allow for faster healing with fewer complications.
While we need to test this technique more thoroughly, so far results have been promising. In 35 early patients who underwent surgery using this technique, we’ve seen good to excellent results in strength, rerupture rate and return to previous level of activity. We believe patients may heal sooner and more completely simply by altering the way the sutures secure the two tendon stumps together.
This may all seem like very technical information to the layperson, but for the quarter of a million people who will tear their Achilles tendon this year, it could quickly become personally relevant.
As a society, we are exercising much later in life than ever before. I have patients well into their 60s and 70s who still run and compete regularly. With the average age of those who tear their Achilles tendon being between 30 and 60, it’s imperative that we take the proper approach to treat them. This is not only so they can get back on their feet faster but also to allow continued enjoyment of the benefits of exercise much longer in life.
Dr. Timothy Miller is an orthopedic surgeon and team physician in the Ohio State University Sports Medicine Department. He’s a published researcher whose interests include the treatment and prevention of stress fractures and overuse injuries of the upper and lower extremities, Achilles tendon tears, gait analysis, dance injuries, arthritis prevention, physical fitness beyond adolescence, biology of bone healing and repair, injuries of the shoulder and elbow in throwers, patellofemoral instability, ACL reconstruction techniques, and endurance athlete physiology. In addition, Miller serves as the team physician for OSU’s men’s and women’s track and field and cross country teams, and is the team physician for Capital University athletics.
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Healing the Heel More Completely originally appeared on usnews.com
