What Is Achilles Tendon Repair?
Achilles tendon repair is a surgery performed to correct a ruptured Achilles tendon. The Achilles tendon is the largest and strongest tendon in the body. Tendons connect muscles to bones, and the Achilles tendon connects the calf muscles—the gastrocnemius and the soleus—to the heel bone (also known as the calcaneus). The tendon helps the foot point downward and is used extensively in walking and running. It can become frayed, partially torn or completely torn, which is known as a rupture.
Common Reasons for Achilles Tendon Repair
A torn or ruptured Achilles tendon can happen for a number of reasons, but is usually related to sports and physical activity. Beginning exercise after a period of inactivity or increasing the frequency, duration or intensity of regular exercise can sometimes lead to an Achilles tendon tear or rupture, as can falls from a height or accidents such as stepping into an unseen hole. Achilles tendon injuries can happen from an acute event or due to chronic stresses placed on the tendon over time, which is known as tendinopathy.
The tendon often tears about two inches above where it connects to the heel bone. This section has poor blood flow, which results in making it particularly injury-prone and hinders the healing of an injury.
Candidates for Achilles Tendon Repair
Surgical repair for the Achilles tendon is typically performed in response to a rupture, or when a partial tear has not gotten better with more conservative treatment methods such as activity modification, icing and resting the injury, and physical therapy.
Achilles tendon repair is suggested more often for acute injuries than for tendinopathy, but surgery may be necessary for severely degenerated tendons.
Achilles tendon repair can be done as either an open procedure or as a minimally invasive procedure. In either case, anesthesia is typically used so the patient feels nothing below the waist. Both surgeries are generally outpatient procedures, meaning the patient can leave the hospital or surgical center within 24 hours of the surgery.
In an open procedure, surgeons make an incision in the back of the leg and pull the skin back. They find the torn or ruptured tendon, stitch it back together and close the incision. If the procedure uses a minimally invasive approach, there is usually more than one incision, but the incisions are typically smaller than in an open procedure.
After Achilles repair surgery, the ankle will need to be immobilized. Weight bearing will be painful and can damage the repair, so it may be necessary to use crutches or a walker for a number of weeks after surgery. It is important to use ice and keep the leg elevated as much as possible in the first few days in order to minimize swelling.
At a follow-up visit a short time (a week or two) after the surgery, the patient will likely be immobilized in a boot or cast. After about four-six weeks, the boot can come off and physical therapy can begin. Most patients can return to normal activity by six months, but full recovery may take up to a year.