Vacocast questions
Hi All,
I’m 2 weeks, 3 days post-op for ATR. I had my stitches out and was put in the boot at 11 days post-op. I brought my Vacosast to the post-op visit, and although the OS wasn’t familiar with it he was fine with me using it instead of the Aircast boot. I left there with it set at 5 degrees with the wedge sole because he seemed like he was having trouble correlating the angle to the 2cm heal lift. That setting felt a little tight, so I moved it to 10 then eventually 15 degrees. He has me on the OWU protocol, and I noticed that the study states that the 2cm heel lift is approximately 20 degrees of plantarflexion.
Has anyone used the Vacocast with the OWU protocol? If so, what settings were used? I’m a little concerned with the Vacocast because it leaves an indentation on the upper part of my incision. Anyone else with a similar experience?
For comparison, I tried out the Aircast boot that I was using before my surgery and it felt like a torture device vs the Vacocast. However, the air bladder might be more forgiving on the incision. Overall it was very uncomfortable.
I’m sticking with the Vacocast, but wanted to know if anyone had similar experiences/concerns.
Thoughts?
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Hi there,
There are people on here who know much more about the study than me, but that protocol was for non-operative treatment of ATR. The timeline works for operative as well but the specific angle for operative somewhat depends on how much your surgeon had to shorten the tendon for reattachment. From your description he didn’t seem concerned so I’m guessing he didn’t have problems but that may change things.
For one reference point, my OS uses the Vacocast so he is familiar with it and gave me the settings. I had a relatively clean rupture and he said he didn’t have to shorten things much. My initial setting was 20 degrees. I have seen others on this site start at 25-30. Oscillot, for one, started at 30 degrees and had surgery.
If it feels tight I would go with more plantarflexion and ease it down later as the tendon heals. Somewhere between 20 and 30 seems to be the norm. If I didn’t have any guidance from my OS, and had to figure it out on my own, I would start at 25 just because it’s in the middle.
Good luck
Hi
I started in the vacocast at 2 weeks post op and had the setting at 3 (30%) for about 1.5 weeks and then moved it to 2.5. gradually moved it by .5 until i got to 6 weeks and then moved it to 0 at my 6 week post op visit.
hope that helps
Thank you both for the helpful comments. I’m just going with what feels right for now, but will put a call in to my OS to make sure I’m not doing anything that will delay or disrupt my recovery. He seemed reluctant to have too much plantar flexion at my post-op visit. I was able to do a push-up, pull-up, sit-up workout with the Vacocast at 15 degrees. I don’t think I would have been able to do it with the Aircast.
The Vacocast should not leave a mark on your incision. Try to shake the internal vacuum liner to even out the beads inside. You may have a point in the liner where the beads have created a bump and is pressing on the incision. Shaking the vacuum liner every day has helped me. My doc was completely unaware of the Pro Achilles, and when he looked into it, he thought it had many advantages over the other available boots. The main problem is that none of the health insurance plans in my area, Pittsburgh, will cover the Vacocast boot, so I had to buy it myself. You would think that with quicker recovery time, fewer PT visits required, fewer side effects on the knees and hips, and fewer re-ruptures with the Vacocast, that the insurance companies would be demanding that it be used. BTW, if you haven’t got an Even-Up yet, do so asap as it helps greatly with the uninjured knee and hip.