Achilles tendon repair & surgery

Achilles tendon repair is the term used to refer to the multiple options for treatment for an Achilles tendon rupture. These injuries are quite common and often require surgery to repair. The Achilles tendon is the strong fibrous cord that connects the two large muscles in the back of your calf to your heel bone. These muscles (the gastrocnemius and the soleus) create the power needed to push off with your foot or rise up on your toes.

Most Achilles tendon injuries happen during recreational activities that require sudden bursts of muscle power in the legs. Often, a torn Achilles tendon can be diagnosed with a physical examination. If swelling is present, the orthopedist may delay the surgery until it subsides.

There are two types of surgery for repairing a ruptured Achilles tendon:

• Open surgery—The orthopedic surgeon makes a single large incision on the back of your leg and sews the two parts of the Achilles tendon back together.
• Percutaneous surgery—During this minimally invasive procedure, the orthopedic surgeon makes several small incisions (instead of a single large incision) and sews the two parts of the Achilles tendon back together.

There are two types of Achilles repair surgery for tendinitis (inflammation of the Achilles tendon), which can be used if nonsurgical treatments aren't effective:

• Gastrocnemius recession—The orthopedic surgeon lengthens the calf muscles to reduce stress on the tendon.
• Debridement and repair—During this procedure, the surgeon removes the damaged part of the Achilles tendon and repairs the remaining tendon with sutures or stitches. Debridement is done when the tendon has less than 50 percent damage.

After open or percutaneous surgery, you will most likely wear a cast or walking boot for six to 12 weeks. At first, it will be positioned to keep your foot pointed downward as the Achilles tendon begins to heal. Gradually, your orthopedic surgeon will adjust it to put your foot in a neutral position, neither up nor down. You may be advised to get an early start to movement and weight-bearing exercises with your cast or boot on. You can anticipate that your recovery time will probably be as long as six months after surgery.

Success rates are high for both types of surgery. Research shows that more than 80 percent of people who have the surgery return to their normal lives and resume all the activities they previously enjoyed, including sports. An average of five out of 100 people will experience a re-rupture of their Achilles tendon, whether they had open surgery or percutaneous surgery.