Quote:
Originally Posted by FAX
Perhaps it's time for a refresher course, Dr. Mecca.
The endoscopic technique used to correct this problem does not require "detaching" the achilles tendon. And the likelihood that the tendon would be accidentally detached during surgery is practically non-existent.
To wit:
A proximal posterolateral portal (PPLP) is first established directly lateral to the Achilles tendon and 5-cm proximal to the Achilles tendon insertion. A 0.5-cm long vertical incision is made through the skin. Care is taken to incise only the skin, and the subcutaneous tissue is spread with a mosquito clamp. Then a blunt trocar is inserted distally to the retrocalcaneal space. After blunt dissection of the adipose tissue anterior to the Achilles tendon, a 4-mm, 30° endoscope is introduced to the retrocalcaneal space. The inflamed retrocalcaneal bursa is then identified.
To make two distal portals—a distal posteromedial portal (DPMP) and a distal posterolateral portal (DPLP) — a spinal needle is inserted directly adjacent to the Achilles tendon at the level of the superior aspect of the calcaneus under direct visualization. Instruments are introduced through the DPMP or the DPLP and visualized through the proximal posterolateral portal (PPLP). To have a better visualization, the excision of inflamed retrocalcaneal bursa is performed using a 4-mm shaver through the DPMP. If necessary, excision is done again through the DPLP.
FAX THE LAY-INTERNIST
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I understand that, the issue would be how bad his spur is and if it can be done with that kind of surgery.
For example I ruptured a tendon and I had an open surgery to have it repaired had they tried to scope me it wouldn't have been repairable because it was worse then expected.