ATR Surgery- Minimally invasive

After the eternity of waiting 3 days to even call an OS and spending every waking minute online researching ATR’s I finally made my appointment and met my doctor.  Since I had such a poor experience with the ER, see previous post, I decided to go with a different OS than they recommended one that serves the Chicago Bulls/Blackhawks and was able to see me right away. 

I meet the OS, he literally wrote protocol for diagnosing ATR with no need for costly MRI, that was pretty neat to hear that he is so passionately involved with ATRs, he was almost a little too excited it seemed to have an opportunity to cut me up and stitch my Achilles back together! but he went over 3 options: no surgery, minimally invasive (sexy incision), or old fashioned full incision.  I immediately said full incision but he explained all the possible complications and I started thinking about the mini as he says there were same amount of reruptures in both and really no drawbacks other than possible nerve damage in the mini vs incision complications with the full.  He informed me how NFL players are choosing both repairs depending on their OS and successfully back in the game, truly no one way better than the other.  I begged him for his favorable opinion one way or the other and he was split right down the middle, has performed the same amount of surgery techniques and hasn’t had any complications or reruptures with either. 

I needed to go home and really research for myself which way to go, he had no problem with that and we scheduled the surgery for the next afternoon.   He actually fit me in as my wife was due with our second child in 2 weeks to the day and he said I would need a full 2 weeks to recover from the surgery before I could be upright not elevating my leg. 

I researched and reached out to friends/family who were in the medical field and my dad who actually had the full incision surgery 15 years ago.  Although he hasn’t had any complications his shoes were very uncomfortable and had to modify to wear and he hasn’t been physically active other than golfing since due to knee problems, and I plan on getting back to sports.

Everything I found was either more positive doing the mini vs. the full incision and it just made more sense to go with the smaller incision as long as everything was lined up, otherwise we have the full incision as the fall back plan should he need to open it up more during surgery.  So I informed the OS minutes before surgery my decision to go with the mini.  I was already drugged up and nerve blocked by that point, woke up and leg was in a cast and I was in a different room around totally different people. “Hey how did my surgery go?!”

Nurse- I am sure it went well but I wasn’t there that team has already left for the night”   me: “huh what the….. well I have like 500 questions, first I was told I will need to elevate my leg after surgery and I’m laying here with my leg down on the hospital bed isn’t that what I’m not supposed to do?”

Given my post op instructions and  free to go home… dead leg and all

Anyone have same surgical/repair options given by OS? How did you make your decision on type of surgery?

2 Responses to “ATR Surgery- Minimally invasive”

  1. Fascinating stuff, Murray! I’d love to hear a recording of everything your ATR-obsessed OS told you — including the pitch on non-op, as well as the surgeries. I think most OSs are more ATR-bored than ATR-obsessed, and have one way they do the op, not two. Some have switched to minimally invasive, usually with a plastic guide/jig to help guide things. (I think 2 others have recently logged in here with that op, unless I’m double-counting you!)

    I think most of us find that lying down flat IS elevating, and we wake up without any/much swelling, even if we don’t use extra pillows. All less so in the first short while after surgery than later, of course. Some people are sure that getting the ATR higher than the heart is vital; me, Not So Much. The higher it is, the lower the blood pressure and inflammation, but every bit helps, and if the swelling is down, it’s down.

    BTW, a year after my second ATR (non-op that time) I went under the knife to get a heart valve replaced, and I discovered a similar discussion around full incision vs. smaller versions. I went with the biggie to make my fancy senior heart surgeon as comfy as possible, and the scar is virtually invisibly faint except for a short bit where it’s covered by black chest hair. No regrets, and I’m back to competitive volleyball.

    And FINALLY: I wonder how common it is for post-op ATR patients to have knee problems, and whether the rate is higher than for others — e.g., the general population and post-NON-op ATR folks. I’ve got a trick knee on my post-op ATR side (ATR #1), where my OS told me he intentionally repaired my AT on the short side, to make sure it didn’t heal too long, which would be bad for running and jumping. My sports-med PT, my podiatrist, and I are all convinced that my short ATR repair is the main cause of my trick knee, which I’m working on, mostly with quad and calf/AT stretches. Hmmm.

  2. I asked my father with the knee problems and he noted that it was his opposite knee of the ATR that is bone on bone. I imagine this might be more common as you heavily overuse the healthy leg during the 6 month period or so. Personally my healthy leg hip joint is killing me every morning now for about a week from one leg standing/squatting to sit and get up, hope that isn’t a sign of more joint pain to come.. but I dont know anything about shortening of the tendon that sounds like it could throw off body mechanics though.

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