PT Podcast Ep. 5: Acute Achilles Tendon Injury скачать в хорошем качестве

PT Podcast Ep. 5: Acute Achilles Tendon Injury

Dan Bien welcomes fellowship-trained in foot and ankle surgeons Brad Blankenhorn, MD and Raymond Hsu, MD to discuss acute Achilles tendon rupture and the management of the injury. Podcast Timeline: 0:00 Acute Achilles injury- Focus on acute Achilles rupture and management. 0:40 Intro/ bios- Current professional roles and background 01:40 Causes and Etiology- Why do Achilles ruptures happen and why do they happen dramatically more often to males in 30’s/40’s? Vascularity/watershed area? 03:25 Diagnosis/ Imaging value- partial tear or musculotendinous junction? 08:24 Decision-making algorithm- conservative vs. operative management o What is the maximal /acceptable time window from date of injury to allow adequate tendon mobilization for a solid repair if that is an option/consideration? How long is too long? o Immobilization timeframes conservative vs. surgical repair? o Comparison of recovery timeframes + retear rate 18:20 Operative management variations in techniques- i.e., Open, Speed Bridge, percutaneous/ minimally invasive - Is there a gold standard and what is your preferred technique and why? 23:19 Orthobiologics value PRP or stem cells 25:23 Rehab controversies o Tendon lengthening- why does it happen following repair and is it avoidable or inevitable? o Weight bearing and how soon? o When to begin resistance and strengthening? o BFR? o Return to running and sport decision-making? Is single LE HR the gold standard? o Screening process/ retear rates/ full return of gastroc-soleus strength? What prevents restoration of strength? What are key considerations that increase susceptibility to retear? 46:13 Final thoughts and recommendations 48:02 Fun personal facts/personal insights