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Researchers find minimally invasive procedure to treat chronic Achilles tendon disorder improves patient outcomes and reduces recovery time

January 13, 2020

A minimally invasive procedure to treat a common foot and ankle disorder can reduce pain, recovery time, and postsurgery complications while improving functional outcomes, according to a report published in the journal Foot and Ankle Surgery.

The procedure treats insertional Achilles tendinopathy, a common and chronic orthopedic disorder in which patients experience pain at the Achilles tendon. The chronic degenerative condition can be particularly painful for athletes who perform push-off activities, such as basketball and soccer players.

The key-hole procedure, known as percutaneous Zadek osteotomy (ZO), can significantly decrease pain and provide a patient with relief in as little as six weeks after this technique compared to 23 weeks for recovery after the traditional open surgery.

"The traditional surgery requires larger incisions and inevitably carries a higher rate of infection, while this minimally invasive procedure has a low infection rate and less risk of tissue damage, helping to better preserve the tendon--and achieve a faster recovery and rehabilitation for the patient," said Ettore Vulcano, MD, Assistant Professor of Orthopedics at the Icahn School of Medicine at Mount Sinai, an orthopedic surgeon at Mount Sinai West, and co-author of the report, which was published online on November 20. "As a result of cutting-edge technology and the latest techniques at Mount Sinai, patients experience much less pain and improved function at a quicker rate. Even athletes can resume previous levels of sports activity at a much quicker rate compared to the traditional surgery."

Dr. Vulcano--one of a few doctors in the nation to revolutionize the minimally invasive approach--said the procedure includes making two very small incisions in the heel and removing a 5mm wedge of bone, which alters the orientation of the tendon fibers and is believed to decrease stress across the tendon.

The short recovery period includes protecting the foot in a splint or walker boot for two weeks, then resuming weight bearing while wearing a removable walker boot for an additional four weeks. Physical therapy can also begin two weeks after surgery. Patients are allowed to return to shoes six weeks after the outpatient procedure. To watch our surgeon explain this procedure click here.
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About the Mount Sinai Health System

The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Geriatrics, Gynecology, Nephrology, Neurology/Neurosurgery, and Orthopedics in the 2019-2020 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 12th nationally for Ophthalmology, Mount Sinai St. Luke's and Mount Sinai West are ranked 23rd nationally for Nephrology and 25th for Diabetes/Endocrinology, and Mount Sinai South Nassau is ranked 35th nationally for Urology. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and Mount Sinai South Nassau are ranked regionally.

For more information, visit https://www.mountsinai.org or find Mount Sinai on Facebook, Twitter and YouTube.

The Mount Sinai Hospital / Mount Sinai School of Medicine

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