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Treating tendons through tiny holes
A new surgery to heal damaged tendons and ligaments could get patients back on their feet faster

 Dr. Ross Girvan performs a Achilles-tendon repair using the TOPAZ method. He is assisted by Gabi Borelli.
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Date published: 8/13/2006

Rosemary Brastrom was an active mother of four and a lifeguard when a car accident damaged both of her Achilles tendons.

She couldn't work. She couldn't even vacuum.

After months of unsuccessful physical therapy, she decided to try a different route: surgery.

"The therapy just wasn't doing anything," she said. "And I'm amazed at how I was then compared to now."

Brastrom, of Fredericksburg, underwent a new type of tendon surgery called TOPAZ.

The method is aimed at mending the torn tendons and ligaments people get from playing sports or doing daily activities, without the trauma that previous sufferers might have endured.

"There's less pain and quicker return to activities than ever before," said Dr. Ross Girvan, a podiatrist with the Fredericksburg Foot & Ankle Center. "The size of the incision we have to make is getting smaller and smaller."

The majority of the surgeries in which Girvan has used TOPAZ were for either Achilles tendinitis or plantar fasciitis, commonly known as heel pain.

Brastrom said that after surgery it didn't take her long to get back on her feet. Girvan performed surgery on one of her feet in April, and on the other in May.

"So it took about six weeks total to be back moving around," Brastrom said.

TOPAZ surgery advocates say that it delivers a more pleasant experience for patients because the incision is smaller, the surgery takes less time and the healing time is less than with traditional tendon or ligament surgeries.

The surgery is performed with a microdebrider, a small wand, while the patient is under mild sedation.

Girvan said the reason the surgery is better than previous treatments is that it actually initiates the healing process.

"The tool just puts a small hole into the tendon at a low temperature, which releases some of the pressure," he said.

Girvan said this means there is increased blood flow.

He explained that the reason tendons and ligaments used to take so long to heal is that the damaged area was removed, but then the tendon or ligament would have to be stitched up and heal naturally.

With TOPAZ, "it's really less about removing the damaged parts and more about creating the healing process," Girvan said.


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