Under The Knife 2/27/23

On PARS

Reader “Battle Creek” asked last week about the advances in Achilles rupture repair and rehab. This could be a book, but I’ll try to summarize. The key is that there have been a bunch of advances in the field, both in surgical technique and in the rehab. You can basically break it down as pre- and post-Kobe Bryant, as his injury is near the changeover. (I’ve tried to run down exactly when the shift happened, but these tend to focus on big stars even if it was first tried on someone’s grandpa.)

The technique is broadly known as PARS (percutaneous Achilles repair system) and this Arthrex page shows you how it works and video if you’d like to see it. There’s variants of it, including some that use the same SutureTape as InternalBrace surgeries. That allows for quicker weight-bearing and less atrophy during the non-load phase, which allows for a quicker rehab. Six months is the generally accepted time, with many surgeons thinking that a full return could be even quicker, but carrying some risk. While the InternalBrace is especially stronger from an early point, no one really wants to test that and stays on the conservative side since even that is significantly faster and more successful.

While players like Michael Soroka show there can be complications, things like his body’s rejection of the sutures are rare. Most will have little or no limitation on return and come back to level in the standard time. We’ve cut the return time nearly in half in a decade and in twenty, Achilles injury has gone from career ender to an arthroscopic fix. It’s pretty impressive and the field isn’t slowing down, even if it is slightly conservative.

For now though, on to the injuries:

OZZIE ALBIES, 2B ATL (shoulder surgery/rehab)

The Braves leaked out that Ozzie Albies had shoulder surgery in the off-season just ahead of the first spring game, explaining why he was DHing. Said to be just a clean-up procedure to deal with a bit of fraying that was irritating, Albies is nonetheless slightly behind in terms of throwing. That’s not an issue with the DH slot available and a month to figure out if he’ll need it at all.

Albies is already hitting and shows no issues with the shoulder, though it’s early. This would likely show up in his power and Albies isn’t going to be mistaken for Aaron Judge or even Ronald Acuna. Absent any setback, I think this surgery can be largely ignored, with only the chance for more regular rest, which might put Orlando Arcia at short more often, a downgrade for the Braves.