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Dr. Bob discusses the PARs procedure and minimally inavasive Achilles tendon repair
PARS for Achilles Rupture
The Achilles, a thick tendon in the back of your ankle, connects the calf muscles to your heel bone. Often medically referred to as the Achilles tendon, the Achilles is essential for running, walking, jumping, and any form of movement that requires pushing off from the ground.
An Achilles tendon injury can significantly impair movement, and the most severe injuries, such as a torn tendon, can necessitate surgery.
If non-surgical treatment is not an option, and you require Achilles tendon surgery, you may want to consider the PARS procedure.
What is the PARS procedure for Achilles rupture repair?
PARS (Percutaneous Achilles Repair System) is a revolutionary minimally invasive treatment for ruptured Achilles tendon repair.
In traditional Achilles tendon surgical repair procedures, such as open surgery, an incision will be made along the back of the calf. An orthopedic surgeon can then remove damaged portions of the torn calcaneal tendon, if necessary, and reattach the tendon.
However, the PARS Achilles tendon operation heals faster thanks to its smaller incision. Through a conservative opening, Dr. Baravarian attaches four high-strength sutures to the ends of the severed tendon. They are then pulled into an hourglass shape, fostering a tighter bond of the tendons that can aid healing. The result is much stronger than previous repair techniques and leaves his patients with essentially no scarring.
What are the benefits of the PARS procedure?
To better understand the advantages of PARS surgery, it’s important to note that during a rupture of the Achilles tendon, the tendon doesn’t rupture cleanly; its fibers shred like frayed rope.
Tendinopathy, a gradual breakdown of the tendon caused by overuse, can also result in a fraying of the tendon fibers.
Dr. Bob's Achilles rupture patient demonstrates Achilles tendon strength just 3 months after the PARS procedure
How does PARS compare to traditional "open repair" surgery?
In traditional tendon repair surgeries, the “open repair” technique is used. The surgeon makes a 10-15cm vertical incision on the back of the ankle and pries open the skin to gain complete access to the Achilles tendon. High-strength sutures are used either to hold both ends of a completely ruptured tendon together or to stitch the edges of a partial tear.
Open surgery is often used for an acute Achilles tendon rupture, as it should be performed within two weeks of the injury. Unfortunately, healing time is lengthy, taking up to nine months. There is also a chance of re-rupture, especially if you return to your previous activity level too soon.
Immobilization via a cast is often required for six to eight weeks, which can lead to tendon weakness, scar tissue formation, and a more pronounced cosmetic impact.
Why choose the minimally invasive PARS surgery?
The benefits of the minimally invasive PARS technique include a very small incision, minimal scarring, and a cleaner, faster recovery. We make a 1 cm horizontal incision across the Achilles region, then slide the PARS repair guide into the healthy portion of the Achilles away from the torn spot.
The PARS device allows the placement of sutures into the healthy tendon ends without the need for a large incision. The sutures allow for a greater area of compression and speedier wound healing.
What to expect during recovery for Achilles surgery
Achilles’ healing time depends on the type of procedure you received. After PARS outpatient surgery, you’ll be placed in a walking boot for the first few weeks.
You’ll start a rehabilitation program around four weeks post-operation to prevent loss of range of motion and help you return to physical activity as soon as and as safely as possible. The recovery process often includes sports medicine-prescribed weight-bearing exercises and physical therapy.
A return to sports activity can occur at approximately three months, which is three months earlier than allowed after open repair surgery.
Regarding wound recovery, the tiny incision typically heals within a week, resulting in minimal scarring. Additionally, the tendon itself heals with a thinner, more natural contour, resulting in a cosmetically appealing reconstruction.
Dr. Bob’s rate of complications following Achilles heel surgery has been less than 1% with the minimally invasive PARS technique. We are proud to note that 97% of patients have returned to their previous level of activity with no long-term complications.
Why Dr. Baravarian is your best choice for Achilles tendon treatment
Dr. Bob is nationally recognized for advanced treatment techniques, including the PARS procedure. He has decades of experience managing the special circumstances and concerns surrounding Achilles tear injuries and ruptures.
For a consultation, please call (855) 557-5400 or make an appointment online now.
Dr. Bob Baravarian is conveniently located in Los Angeles, near Cedars-Sinai Medical Center, providing expert foot and ankle care for patients throughout Southern California.
Achilles tendon surgery FAQs
How are Achilles tendon tears diagnosed?
A physical examination using the Thompson test, which evaluates the integrity of your Achilles tendon, can inform the doctor if there are any Achilles tendon tears. An X-ray can confirm the diagnosis and show signs of tendinitis. Based on the findings, we may prescribe non-operative treatment or recommend surgery.
Can tendon surgery cause nerve damage?
Orthopedic surgery carries risks, although they are usually minimal. Nerve pain or discomfort can occur after surgery because the sural nerve is often located near the tendon. It’s essential to report any discomfort to your healthcare provider at your follow-up appointment, as rest, physical therapy, and strength-building exercises can help prevent and alleviate Achilles tendon surgery-related nerve pain.
Can acute Achilles tendon rupture (ATR) cause a blood clot?
There is some association between acute Achilles tendon rupture (ATR) and deep vein thrombosis (DVT). Immobilization may cause issues with circulation and blood supply, making it essential that you visit your healthcare provider if you have any concerns before or after surgery.
