Researchers Find Minimally Invasive Procedure to Treat Chronic Achilles Tendon Disorder Improves Patient Outcomes and Reduces Recovery Time
A minimally invasive procedure to treat a common foot and ankle disorder can reduce pain, recovery time, and postsurgery complications while improving functional outcomes, according to a report published in the journal Foot and Ankle Surgery.
The procedure treats insertional Achilles tendinopathy, a common and chronic orthopedic disorder in which patients experience pain at the Achilles tendon. The chronic degenerative condition can be particularly painful for athletes who perform push-off activities, such as basketball and soccer players.
The key-hole procedure, known as percutaneous Zadek osteotomy (ZO), can significantly decrease pain and provide a patient with relief in as little as six weeks after this technique compared to 23 weeks for recovery after the traditional open surgery.
“The traditional surgery requires larger incisions and inevitably carries a higher rate of infection, while this minimally invasive procedure has a low infection rate and less risk of tissue damage, helping to better preserve the tendon—and achieve a faster recovery and rehabilitation for the patient,” said Ettore Vulcano, MD, Assistant Professor of Orthopedics at the Icahn School of Medicine at Mount Sinai, an orthopedic surgeon at Mount Sinai West, and co-author of the report, which was published online on November 20. “As a result of cutting-edge technology and the latest techniques at Mount Sinai, patients experience much less pain and improved function at a quicker rate. Even athletes can resume previous levels of sports activity at a much quicker rate compared to the traditional surgery.”
Dr. Vulcano—one of a few doctors in the nation to revolutionize the minimally invasive approach—said the procedure includes making two very small incisions in the heel and removing a 5mm wedge of bone, which alters the orientation of the tendon fibers and is believed to decrease stress across the tendon.
The short recovery period includes protecting the foot in a splint or walker boot for two weeks, then resuming weight bearing while wearing a removable walker boot for an additional four weeks. Physical therapy can also begin two weeks after surgery. Patients are allowed to return to shoes six weeks after the outpatient procedure.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai advances medicine and health through unrivaled education and translational research and discovery to deliver care that is the safest, highest-quality, most accessible and equitable, and the best value of any health system in the nation. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture ambulatory surgery centers; more than 415 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. The Mount Sinai Hospital is ranked on U.S. News & World Report's "Honor Roll" of the top 20 U.S. hospitals and is top in the nation by specialty: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. Mount Sinai Kravis Children's Hospital is ranked in U.S. News & World Report’s “Best Children’s Hospitals” among the country’s best in four out of 10 pediatric specialties. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and No. 14 in the nation for National Institutes of Health funding. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.