Dr. Jung opinion sought on new Speed Bridge procedure that enhances a more rapid return-to-play outcome.
Article Links: Article | Outpatient Surgery Magazine (aorn.org)
Fans of the only-a-quarterback-away New York Jets were rightly full of hope when future Hall of Fame signal-caller Aaron Rodgers took the field at MetLife Stadium for the season opener on Sept. 11. Their emotions turned to dread four plays into the game, however, when Rodgers tore his Achilles tendon.
Most fans assumed his season was certainly over. While that might still wind up being the case, Rodgers has said he plans to play this year, and he stunned people when he began throwing passes before games only weeks after his surgery.
Rodgers underwent a “speed bridge” procedure performed by Neal ElAttrache, MD, of the Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. The innovative procedure is part of the reason that such a rapid return to the field for Rodgers is even a possibility, says Kenneth Jung, MD, a colleague of Dr. ElAttrache’s at Kerlan-Jobe. Dr. Jung is a foot and ankle consultant to the Los Angeles Rams, Los Angeles Kings and Anaheim Ducks.
The speed bridge procedure employs an extremely strong polyethylene suture over the distal end of the tendon in an hourglass pattern that is anchored into bone with four screws, allowing a knotless repair and large area of compression that lets patients put weight on their foot with a significant range of motion almost immediately after surgery.
“The speed bridge technique is an element of a surgeon’s armamentarium that they can utilize,” says Dr. Jung. “In this case, when you’re taking care of an elite athlete, it’s a stronger repair that allows him to push the rehab envelope and see where he can get to as far as a quick return.”
The speed bridge procedure isn’t something that’s only selected for pro athletes. Its use is fairly common and increasing all the time. It’s only one of the reasons that outpatient foot and ankle procedures are advancing, however. Dr. Jung credits the ever-expanding use of regional anesthesia as perhaps the most important development. Pain control issues were the biggest reason for keeping someone for observation overnight. Now, not only are most of his cases performed at surgery centers, but even most of his patients who undergo their surgeries in the hospital are allowed to go home the same day. “Here in Los Angeles, for example, anyone who has to wait until the general anesthesia has worn off and gets discharged after 3 p.m. has a two- to three-hour drive home,” explains Dr. Jung. “Regional anesthesia allows their pain to be controlled so they can get home sooner and get situated. The blocks are good for 12 to 24 hours, so we can explain to the patients that there’s no difference between being in the hospital or at home if your pain is controlled.” While recovery times are faster for patients who underwent a speed bridge procedure compared to a more traditional Achilles repair, patients such as Rodgers still have advantages most patients do not.
“Professional athletes are getting paid to get back as quickly as possible, so the rehab is part of their job,” says Dr. Jung. “The rest of us go to rehab and physical therapy a few times a week, but elite athletes have the time and incentive to do much more. They can take more risks while pushing the envelope, because the windows for them to play are very short.”