Pars Method for Achilles Tendon Rupture

by Heather D
(Port Elizabeth, South Africa)

I had tendonitis on and off for a couple of years. I snapped my tendon on the 9th of July 2018 whilst participating in a 21 km run, at the 4 km mark. The pain was excruciating. I made an appointment with a specialist and he gave me three options: no surgery/ surgery / or the PARS surgery method. I opted for the PARS technique.

Day 1 after surgery i was in a cast and hours after the op i was up and weight bearing about 20% on my toes, this i did for two weeks.

After two weeks the cast was removed and few little stitches were removed. A new cast in a different foot position was done for another two weeks and was told to bear more weight on the foot. At the four week mark my cast was removed and i have gone into the boot with no wedges- normal flat footed and bearing full weight.

This is my experience so far.

I only had a pain of about 8/10 for the first five days, thereafter i stopped all pain meds and just felt a slight discomfort. When i went into the second cast and then again into the boot, i felt a little discomfort for first day or so, but nothing to moan about.

My scar is beautifully healed and my swelling is minimal when i wake up in the morning, but if i do too much then it does swell a little. In the house i am not wearing the boot, but walking very slowly and carefully.

I am doing a few exercises which include ankle rotation and using the band to strengthen calf. I researched a lot before and after surgery and honestly think i chose the correct option as it seems to be working for me.

4 weeks post surgery and i will commence driving in a few days (as i have good movement of the foot) and i will start my swimming in two weeks time. I really can say that this is a horrible experience to go through, and at times i am tearful, but since i can now walk without the crutches i have more independence.

My ankle is stiff and tight and i have lost my calf muscle, but i am positive that all will be regained soon. My goal is 4-5 months to be back to normal. I really believe the bit of weight bearing from word go was key, but must stress that one must follow Dr's orders.


Joshua Answers:

Hi Heather.

Thanks for sharing your experience here! And you're the first person that has mentioned the PARS technique for achilles tendon rupture surgery and repair.

For those that don't know, the PARS of the technique stands for 'Percutaneous Achilles Repair System'.

It boasts:

- Minimal incision reduces risk of wound complications
- Provides the ability to create a locking stitch
- Easy suture management

And as a perk for the surgeons, it is a 'Reusable device with numbered, easy to follow steps'.

All in all it
looks like it allows for increased ability to A. grab the two ends of the ruptured tendon and B. suture them to gether in a very good/strong way (allowing for stronger healing and overall stronger/better repair)

And Heather, from your description of your recovery...all in all that has been a very good/fast recovery so far. Maybe because of factors you bring to the table (high pain tolerance, healthy tissue, strong overall system health for fast healing and low tendency for the system to panic and go into crazy defensive mode lots of pain, basically).

So that's awesome. Lots of people's recoveries are long and traumatically painful.

If that's due to the surgery technique, that's a big deal.

Here is a collection of achilles rupture surgery/recovery stories. See: Achilles Tendonitis Surgery Stories

So. It all starts with Achilles Tendonitis. Even if you didn't have any symtoms that you could feel (tightness, pain, etc), the tendonitis dynamic is in play.

See: What Is Tendonitis?

See: Pain Causing Dynamic

The very short version of that is that your lower legs weren't functioning as well as they could be/should be.

Force wasn't being absorbed. All that force still had to go to the spot where the rupture happened.

Achilles Tendonitis Surgery is just a matter of going in and 'cleaning up' the tendon (which means they go in and shave the surface of the tendon...somehow thinking that is going to fix the problem).

An Achilles Tendon Rupture, as you know/as seems obvious, is an entirely different animal. The big thick tendon is completely severed. For repair there has to be incision(s), go in and grab the two ends, hold them together WHILE sewing them tightly together.

And then they have to stay together while the ends heal together.

Weight bearing IS good. But it has to be be just enough to signal the body (to make the spot stronger) and NOT enough to tear it apart. That can be tricky, and why as strong a suture as possible is called for.

Be very careful walking around carefully. Some people trip and/or come down unexpectedly hard on that foot and bang the sutures fail and the tendon separation happens again (partially or completely) that's no bueno.

So don't do that....while pushing the edge just enough.

Overall, it sounds like you have it handled, great!

Please keep us updated.

Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

And, comments have a 3,000 character limit so you may have to comment twice.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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