In his PT Podcast, University Orthopedics Physical Therapist Dan Bien discusses the role of therapy related to various orthopedic injuries and surgeries.
University Orthopedics Foot and Ankle surgeons Dr. Brad Blankenhorn and Dr. Raymond Hsu join Dan for Episode 5 to discuss acute Achilles injuries and the latest treatment options.
Podcast Timeline:
- 0:00 Acute Achilles injury- Focus on acute Achilles rupture and management.
- 0:40 Intro/ bios- Current professional roles and background
- 01:40 Causes and Etiology- Why do Achilles ruptures happen and why do they happen dramatically more often to males in their 30s/40s? Vascularity/watershed area?
- 03:25 Diagnosis/ Imaging value- partial tear or musculotendinous junction?
- 08:24 Decision-making algorithm- conservative vs. operative management
- What is the maximal /acceptable time window from date of injury to allow adequate tendon mobilization for a solid repair if that is an option/consideration? How long is too long
- Immobilization timeframes conservative vs. surgical repair?
- Comparison of recovery timeframes + retear rate
- 18:20 Operative management variations in techniques- i.e., Open, Speed Bridge, percutaneous/ minimally invasive – Is there a gold standard and what is your preferred technique and why?
- 23:19 Orthobiologics value PRP or stem cells
- 25:23 Rehab controversies
- Tendon lengthening- why does it happen following repair and is it avoidable or inevitable?
- Weight-bearing and how soon?
- When to begin resistance and strengthening?
- BFR?
- Return to running and sports decision-making? Is single LE HR the gold standard?
- Screening process/ retear rates/ full return of gastroc-soleus strength? What prevents restoration of strength? What are key considerations that increase susceptibility to retear?
- 46:13 Final thoughts and recommendations
- 48:02 Fun personal facts/personal insights
About Dr. Brad Blankenorn
Dr. Brad Blankenhorn specializes in the treatment of common and complex disorders of the foot and ankle. His practice focuses on reconstructive surgery for deformity and degeneration in the foot and ankle, as well as the treatment of acute and subacute traumatic injuries to the foot and ankle.
Dr. Blankenhorn has experience in the treatment of arthritic conditions of the foot and ankle, including joint fusions and total ankle replacements. His practice also includes the arthroscopic treatment of traumatic, arthritic, and sports related injuries of the foot and ankle.
About Dr. Raymond Hsu
Dr. Hsu specializes in the disorders of the foot and ankle. He treats acute traumatic injuries including fractures, cartilage injuries, ligament sprains, and tendon tears. He also treats chronic conditions such as arthritis, deformity, and other sequelae of old injuries. He is trained and experienced in orthopedic trauma in general, but his particular interest is in the repair and reconstruction of the foot and ankle.
Dr. Hsu’s research interests include the impact of lower extremity fractures in the elderly population, biomechanics of fracture fixation, efficient resource utilization in orthopedics, occupational radiation exposure for surgeons, and appropriate use of advanced imaging.
About Dan Bien
Dan Bien is a physical therapist at our Kettle Point Campus in East Providence. Dan has worked at University Orthopedics since 2006 and serves as the Coordinator of Clinical Education for the physical therapy department.
Dan is currently recognized as an Orthopedic Certified Specialist by the American Board of Physical Therapy Specialties, a Certified Strength and Conditioning Specialist through the National Strength and Conditioning Association, and a Credentialed Clinical Instructor by the American Physical Therapy Association.