This question is a perfect example for understanding the anatomy, biology, physiology, and biomechanics of Achilles tendon ruptures and insertional tendonitis. The aim of surgical repair is to provide a biomechanical advantage for these injuries and a greater load-to-failure speedier recovery.
The Achilles tendon anatomical compartment is created by the soleus, medial, and lateral gastrocnemius muscles, which should be noted form the strongest tendon in the body. Achilles tendon ruptures and tendinopathy make up two the most common traumatic and overuse injuries in the athlete.
The Arthrex SpeedBridge technique is an advanced minimally invasive surgery typically performed for tendon repair of distal Achilles tendon rupture and insertional Achilles tendonitis. The surgical approach is generally a posteromedial longitudinal incision along the posterior calcaneal tuberosity and Achilles tendon insertion, dissecting down to the medial border of the Achilles tendon. The advantage here is direct approximation of tendon ends and an assessment of tendon length, being careful not to disrupt the blood supply to the tendon. The distal attachment of the Achilles tendon is reflected from the posterior calcaneal tuberosity and the retrocalcaneal bursa is excised to eliminate it as a generator of postoperative pain. Surgical failure may occur from overtensioning of the tendon and surrounding tissue.
The SpeedBridge repair is an innovative soft-tissue fixation device, enabling a unique hourglass pattern of sutures over the distal end of the tendon. Most notably, this ingenious 4-anchor construct enables a knotless repair and greater focal compression area for the Achilles tendon on the calcaneus, improving stability in weightbearing and range of motion. Additionally, islands of elemental silver and zinc are embedded in the surgical dressing which is designed to generate electrical microcurrents to initiate cell migration for wound healing.
The overall goal of the Arthrex SpeedBridge technique is to develop a simple method to improve Achilles reconstructive surgery with an innovative failsafe potential of increasing load to failure stability and biomechanics in these repairs.
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