Latest Surgical Technique - Arthrex Midsubstance Speedbridge Achilles knotless Repair

I am new to this forum, and have read a lot of posts. There is some great information. Thank you to all who contribute.

However, I don’t see a lot of information about the type of surgery that people have undergone, and thought I would share the links below. I did a lot of research and was very fortunate to find a surgeon in Florida doing the procedure. He has been doing it for about a year on all fully torn achilles, including several professional athletes. I am now almost 6 weeks post ATR surgery. I had the procedure done 9 days post ski crash full ATR in Colorado. The surgery lasted 40 minutes, I have minimal scarring, very little post-surgery swelling, and no pain. I am 48 years old and in good shape. 2 weeks post-surgery I had the splint case removed and bought the fancy Vacocast Vacoped achilles boot (totally worth the $300). At 4 weeks I started PT and partial weight bearing. Again, very little swelling and no pain. I am walking now in the boot without a crutch fairly well. If the wound was completely healed my surgeon assured me I could be walking without the boot. He insists I will be playing golf at 10-12 weeks post ATR surgery in normal shoes and doing backflips at 4 months (I don’t do backflips but you get the gist).

I will update later to confirm that and my progress, but I already have good range of motion and feel like I could walk in shoes now. The benefit of this surgery is that it is minimally invasive, very low risk of nerve injury, very strong, and has no knots that can come apart. The videos from the Arthrex site are really information and convincing. Curious if others have undergone this specific procedure and how they are doing….

Here are a few links…

https://www.arthrex.com/foot-ankle/achilles-midsubstance-speedbridge-repair

https://m.arthrex.com/resources/presentation/wREBpyd-_UGyRwFgvCaP4Q/achilles-midsubstance-speedbridge-repair

https://www.arthrex.com/resources/videos-case-presentations/blJIThXB8kC9CwFZZaNyJg/achilles-midsubstance-surgical-repair-using-the-achilles-midsubstance-speedbridge-system

Update: 6/13/2018 Dr. visit today.  went to 2 shoes full weight bearing no crutches.  6 weeks, 5 days post ATR surgery.  Dr. says no concerns that tendon will rupture but to be careful and use boot in airports, etc.  Continue to more PT, but watch the wound and make sure healed before running and strenuous exercise.

9 Responses to “Latest Surgical Technique - Arthrex Midsubstance Speedbridge Achilles knotless Repair”

  1. hi there - i’m 2w2d post op. i had a “mini-open” surgery but that is all i know about the procedure itself. i’m sure i did not have what you described. he talked about sewing the ends together. i’ve been through a lot of this site and have to found anybody describing what you are describing in terms of operative technique.

  2. My doc used the speedbridge on for my surgery as well. I didn’t even read my operating report until a year after the surgery when I found out that’s what he used (and that’s what he always uses if he can). My surgery was to remove a large bone spur as opposed to a rupture so it was a bit different than some.

  3. I had the PARS technique surgery last August - horizontal incision about 1.5 inches long, then a jig to pull the pieces together and stitch them up. When I researched it after my injury, I only found conservative treatment, classic vertical incision, and PARS. I don’t understand how the Arthrex surgery would have people doing backflips at 4 months, but minimally invasive is a good thing even if the recovery is the same as other methods.

  4. I totally agree that minimally invasive is a good thing. Very small incision, shorter surgery, and fewer complications. My understanding is that your PARS procedure and the Speedbridge are actually not that different. The “jig” you mention was probably made by Arthrex. See this link - https://www.arthrex.com/foot-ankle/pars-achilles-jig-system

    The PARS jig pulls the broken ends of the tendon together using fiberwire, but there is no stitching the broken ends together like with an open traditional repair. This avoids a lot of scar tissue and potential nerve damage and allows the tendon to heal naturally. The Speedbridge just avoids tying any knots at all by placing two anchors in the heel bone and wrapping the fiberwire around the anchors instead of tying them together.

    Both procedures are pretty brilliant from a simplicity and effectiveness standpoint. I am surprised there is not more discussion about it here. Maybe it is not yet mainstream.

    How long did it take you to walk in two shoes ? Curious b/c I am hoping to get there very soon.

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  5. It took me 11 weeks to get to two shoes - the surgeon made me wait longer than normal because my rupture was at the top end of the tendon (muscle on one side, tendon on the other) and those take longer to heal. I got pretty good at power hobbling with my boot on while I was waiting though!

  6. I also had the Speedbridge repair done. I’m only 3 weeks post-op so I don’t have a lot of feedback on it yet, but I too feel fortunate to have had it. Incisions are minimal, relatively speaking, so the pain was not bad.

    I started pwb in the boot (3 wedges) with doc’s approval a few days ago. Surprisingly, weight bearing “as tolerated” meant I stopped using the crutches two days later! I am not trying to rush it and I don’t feel like I have something to prove; rather quite the opposite, I am trying to follow directions like I never have before so I get through this with no complications if at all possible. It’s just that once I got used to the sensation of weight bearing, I felt virtually no difference between partial and full. I completely understand that the scariest steps are still ahead of me with wedge removal and eventual two shoes. I am just so happy to be able to make a cup of tea AND carry it to the couch, that I’m enjoying this milestone that gave me back some independence!

    Sorry, got sidetracked there with the celebrating…
    Are there other Speedbridgers out there?

  7. And curiosity question, nielsmurph, did you have a horizontal or vertical incision? Thought I had read that it’s typically horizontal, but mine is vertical.

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  9. Great topic of discussion, really didn’t know there was a couple different techniques being used. Pretty sure I had the PARS and am 10 days Post-Op. The biggest thing I take away from the Speedbridge technique is “early motion”. I’ll be talking to my doctor about that topic, which seems to be a very common discussion point in a lot of these forums.

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