174: The Comeback Step: Game-Changing Foot & Ankle Surgery

In this The Sports Docs Podcast episode, Dr. Ashley Bassett and Dr. Catherine Logan sit down with foot and ankle experts Dr. David Pedowitz and Dr. Josh Metzl.From evolving surgical techniques to implant innovation and accelerated return-to-play timelines, this conversation highlights how modern approaches are reshaping outcomes for high-level athletes.Achilles Tendon InjuriesWho Needs Surgery? Best suited for young, active athletes, especially in explosive or cutting sports  While nonoperative care has improved: Tendon elongation remains a key concern Push-off strength deficits can impact performance  Surgical repair offers:  Faster strength recovery  More predictable return to sport Evolution of Surgical Technique Shift from open surgery → minimally invasive (MIS) and percutaneous approaches Benefits:  ↓ wound complications  Improved cosmesis  Faster rehabilitation Double-row fixation restores native footprint and improves gap resistance PARS Technique (Percutaneous Achilles Repair System) Combines precision of open repair with less soft tissue disruption Key features:  Small incision with percutaneous suture passage  Reproducible jig-guided technique  Strong, locking suture construct  Ideal for acute midsubstance rupturesPearls: Master jig orientation before live cases  Maintain tension during suture passage  Protect the sural nervePitfalls: Incisions too small → poor visualization  Overtensioning the repair Repair Constructs: PARS vs SpeedBridgeSpeedBridge (double-row, knotless):  ↓ tendon elongation  Strong biomechanical construct  Slight ↑ risk of heel pain PARS:  Less invasive  Lower wound complication rates Insertional Achilles Pathology Typically treated with open or MIS SpeedBridge techniques MIS FiberTak SpeedBridge advantages:  Smaller incisions  Less implant material  Strong fixation with rip-stop construct Supports early weight-bearing and mobilizationReturn to Play90% return to sport after surgery Typical timeline: Running: progressive, athlete-specific Full return: ~6–9 months 🎧 Listen & SubscribeIf you enjoyed this episode, be sure to subscribe, rate, and review on:Apple PodcastsSpotifyFollow us on Instagram Arthrex Team Physician Controversies 2026Our Hosts:Ashley Bassett, MD & Catherine Logan, MD, MBA / www.cosportsmedicine.com