Achilles tendon repair surgery may be required after a patient sustains an injury to the Achilles tendon. In this video, I will be describing the Arthrex Midsubstance Achilles Repair Procedure.
This video outlines the Arthrex Midsubstance Achilles Repair System.
As you can see in this video, the initial incision is made horizontally. However, I like to make my incisions more vertical just in case the incision needs to be extended.
The device you see here is called the percutaneous Achilles repair system, as it’s a device that traverses underneath the skin to capture the Achilles. As these needles pass, you can see the sequential sutures are all passed to capture the proximal stump of the Achilles. This avoids the need for the typical large Achilles incision used in traditional repair procedures.
Next we use a locking stitch to create a capture of the proximal stump. Once the proximal Achilles stump is captured, we make two stab incisions onto the proximal calcaneus on a posterior aspect. We drill and we tap to anchor our midsubstance repair kit. As we know, the common area where this fails is in the knot. This effectively bypasses that failure point.
After we tap, then the suture lasso is passed through the distal stump, capturing the sutures on both the medial and lateral side of the Achilles.
Once the sutures are passed, we cycle the Achilles to bring the two stumps together. Once there is a good proximity, we then tap the sutures down with a screw. What’s not pictured in this video, is I also use a stitch to repair the stump directly to give it more reinforcement. I also apply an amnion patch (which is made of umbilical cord tissue) prevent scarring and promote healing. On occasion I will also employ the use of stem cells.