Achilles Tendon Repair: Rupture

The 26 Review

  • What is Achilles Tendon Repair Achilles tendon repair surgery fixes damaged (ruptured) achilles tendons
  • How Ruptured ends of the tendon are sewn back together
  • Why Surgery is recommended for patients to repair function of the Achilles
  • Recommended for Patients experiencing sharp pain and loss of function including difficulty walking or standing
  • Length of Treatment Surgery lasts 1-2 hours, depending on the severity of the rupture
  • Downtime 12 weeks to fully heal
26 Foot and Ankle Achilles Tendon Rupture

Let’s take a closer look…

The Achilles Tendon is a long, thick band of connective tissue that attaches the calf muscles to the heel bone. It is the longest and strongest tendon in the body, meant to endure stress from daily activities and sports. The achilles tendon allows us to walk, run, jump, and stand on our toes. However, the achilles tendon can tear, rupture, and degenerate over time. Typically a tear or rupture occurs due to a sudden, strong force during tough physical activity. A rupture can also occur during unusual fast movements or pivoting the foot. Those with a foot that naturally turns outward are at larger risk for a torn tendon. A rupture achilles tendon can cause pain, bruising, and swelling near the back of the calf and heel. Patients who can not bend their foot downward or struggle to walk or stand may be experiencing a rupture tendon. Achilles tendon repair surgery may be helpful for patients who have tendon injuries that make it difficult for them to move a joint or are unbearably painful.

Procedure Details: Pre, During & Post Surgery Expectations

Prior to diagnosis, a podiatrist will perform an initial examination to determine the type of injury a patient is facing. This diagnosis will likely include a physical exam and discussion on the cause of injury. A medical professional will examine the ankle and calf muscles, assess their ability to move in varying directions, and determine how they respond to pressure. The podiatrist will also feel the achilles tendon to check for a rupture or a “tendon gap”. A Thompson test most likely will be performed, as well as, an MRI or ultrasound to determine the severity of the injury.

Before the surgery, speak with your healthcare provider to devise a plan on how to effectively prepare for the surgery. Patients should inform their healthcare provider of all prescription medications and OTC medicines taken daily. In certain cases, some patients may need to stop taking some medications prior to their surgery. Those who smoke are advised to stop before surgery, seeing as smoking can delay healing. As mentioned previously, an MRI, X-ray, or ultrasound may be required prior to surgery. Inform your doctor of any recent changes in your health, such as a fever.

During the surgery, patients may receive a local anesthesia injected into the spin, so that anything below the waist won’t be felt during surgery. Patients are also likely to receive sedation, in order to sleep through said surgery. As the surgery begins, the surgeon will make a small incision through the skin and muscle of the calf. From there, the surgeon will make another incision through the sheath that surrounds the tendon. Depending on the severity, a surgeon will do one of two things. For most repairs, a surgeon will only have to stitch the tendon back together, to fix the rupture. For more severe cases, the surgeon may remove parts of the damaged tendon and replace it with a stronger tendon from the leg. Once the surgery is completed, the podiatrist will close the layers of skin and muscle around the calf with sutures.

Achilles tendon repair is an outpatient surgery, meaning patients can return home the same day as their surgery. Patients are required to have someone drive them home after said surgery. After the surgery is concluded, patients are encouraged to wait in the recovery room for at least 1 to 2 hours. As mentioned before, healing can take up to 12 weeks. The injured tendon may need to be supported during this time with a splint, cast, or boot to take the tension off the repaired tendon. The first few days after surgery patients can expect to feel soreness or stiffness. OTC pain medications can be taken to alleviate post-surgery soreness. Patients are urged to keep their affected leg elevated as often as possible, to reduce swelling and pain. After the surgery, patients will likely need to use crutches to keep as much weight off the leg as possible. About 10 days after surgery, patients will have their stitches removed. Your healthcare provider might replace the splint with a cast or boot at this time. Physical therapy may be encouraged for patients to help strengthen the ankle and leg muscles during recovery.

Benefits and Risk Factors

Like most surgeries there are significant benefits and risk factors to consider. After tendon repair surgery, patients feel significant pain relief and dissipating symptoms. This surgery successfully repairs tendon ruptures, allowing patients to resume everyday life activities and workouts. Once a ruptured tendon is repaired, actions like walking, running, standing, and jumping will begin to come with ease. Tendon repairs can be highly successful with the right podiatrists and proper post-surgery physical therapy. The sooner a tendon is repaired after an injury takes place, surgery and recovery becomes easier for everyone involved. In certain cases, long-term complications can develop, such as long-lasting stiffness. Excess bleeding, nerve damage, infection, and calf weakness are all potential risk factors that can occur. Although tendon repair surgery complications are rare, if they do occur they are typically easy to treat. Personalized patient risks may vary according to age, shape of the foot and leg muscles and tendons, a patient’s general health, and specific type of surgery done. Speak with your podiatrists to discuss all potential risks and concerns you may have.

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