CME OnDemand: New Advances in Sports and Forefoot/MIS - What's New and What's Next?-Achilles Tendon Tears

Video Transcription
Video Summary
The video is a lecture by Dr. Ken DeFantis on the diagnosis, treatment, and outcomes of Achilles tendon tears. He is a practicing physician at Towson with Big Associates, affiliated with the University of Maryland St. Joseph Medical Center. Dr. DeFantis begins by discussing the objectives of the talk, which include reviewing the presentation and diagnosis of acute Achilles tendon ruptures, discussing treatment options (operative and non-operative), reviewing outcomes of non-operative and operative treatment, discussing minimally invasive repair techniques, and comparing traditional open techniques to minimally invasive techniques.<br /><br />Dr. DeFantis highlights the incidence and demographics of Achilles tendon ruptures, mentioning that they are relatively common, more likely to happen in men, and can be seen in a wide age range. He discusses predisposing factors such as inflammatory conditions, fluoroquinolone antibiotics, corticosteroid use, and pre-existing Achilles tendinosis. He also discusses the importance of history taking and clinical examination in diagnosing Achilles tendon ruptures, as well as the use of imaging modalities like x-rays, ultrasound, and MRI.<br /><br />The lecture covers treatment options, including non-operative management (cast immobilization and early functional rehabilitation) and operative management (open repair and minimally invasive repair). Dr. DeFantis explains the advantages of minimally invasive techniques, which include reduced risk of wound complications, and presents his own technique using a bent sponge stick to percutaneously thread sutures through the tendon. He also discusses post-operative care and rehabilitation protocols.<br /><br />The lecture addresses various complications associated with Achilles tendon tears, including re-rupture, wound dehiscence, infection, nerve injury, and deep venous thrombosis. Dr. DeFantis advises on risk factors to consider when deciding on surgical versus non-surgical treatment, such as smoking and diabetes mellitus.<br /><br />Dr. DeFantis concludes by discussing the current evidence on operative versus non-operative treatment, stating that there is no clear consensus and that the decision should be based on a patient's age, risk factors, and activity level. He also mentions the recent trend towards minimally invasive repair techniques. The lecture emphasizes the importance of patient counseling, managing expectations, and setting realistic timelines for return to activities and sports.<br /><br />Overall, the video provides a comprehensive overview of Achilles tendon tears, their diagnosis, treatment options, and outcomes, with a focus on minimally invasive repair techniques.
Keywords
Achilles tendon tears
diagnosis
treatment options
outcomes
minimally invasive repair techniques
non-operative management
operative management