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Achilles Tendon Repair Surgery

What is Achilles tendon repair surgery?

Achilles tendon repair surgery is a type of surgery to fix a damaged Achilles tendon.

The Achilles tendon is a strong, fibrous cord in the lower leg. It connects the muscles of your calf to your heel. It’s the largest tendon in your body. It helps you walk, run, and jump.

In some cases, the Achilles tendon can tear, or rupture. This is usually due to a sudden, strong force. It can happen during tough physical activity. It can happen if you suddenly move faster or pivot on your foot. Having a foot that turns outward too much can increase your risk of a torn tendon. A ruptured Achilles tendon can cause pain and swelling near your heel. You may not be able to bend your foot downward.

The Achilles tendon can also degenerate. This is also known as tendinitis or tendinopathy. This might cause symptoms like pain and stiffness along your Achilles tendon and on the back of your heel. This is most often through overuse and repeated stress to the tendon. It can happen from repeated stress on your tendon, especially if you've recently been more active. Having short calf muscles can increase your risk of tendinopathy.

During the surgery, an incision is made in the back of the calf. If the tendon is ruptured, the surgeon will stitch the tendon back together. If the tendon is degenerated, the surgeon may remove the damaged part of the tendon and repair the rest of the tendon with stitches. If there's severe damage to a lot of the tendon, the surgeon might replace part or all of your Achilles tendon. This is done with a tendon taken from another place in your foot.

In some cases, the Achilles tendon repair surgery can be done as a minimally invasive procedure. This is done with several small incisions instead of one large one. It may use a special scope with a tiny camera and a light to help do the repair.

Why might I need Achilles tendon repair surgery?

You might need Achilles tendon surgery if you tore your tendon. Surgery is advised for many cases of a ruptured Achilles tendon. But in some cases, your healthcare provider may advise other treatments first. These may include pain medicine or a temporary cast or boot to prevent your leg from moving. And your provider may not advise surgery if you have certain medical conditions. These include diabetes and neuropathy in your legs.

Or you may need Achilles tendon repair surgery if you have tendinopathy. But in most cases, other treatments can be used to treat tendinopathy. These include resting your foot, using ice and pain medicines, and wearing a brace or other device to stop your foot from moving. Physical therapy can also help. If you still have symptoms after 6 months, your provider might recommend surgery.

Depending on the type of problem you have, Achilles tendon surgery might work for you. Talk with your provider about the risks and benefits of your choices.

What are the risks of Achilles tendon repair surgery?

Every surgery has risks. Risks of Achilles tendon repair include:

  • Excess bleeding

  • Nerve damage

  • Infection

  • Blood clot

  • Wound healing problems

  • Calf weakness

  • Complications from anesthesia

  • Continued pain in your foot and ankle

  • Rerupture of the Achilles tendon

Your own risks may vary according to your age, your general health, the type of surgery done, and the shape of your foot, leg muscles, and tendons. and Talk with your healthcare provider about any concerns you have. They can tell you the risks that most apply to you.

How do I get ready for Achilles tendon repair surgery?

Talk with your healthcare provider about how to prepare for your surgery. Tell your provider about all the medicines you take. This includes over-the-counter medicines, such as aspirin. You may need to stop taking some medicines ahead of time, such as blood thinners. If you smoke, you’ll need to stop before your surgery. Smoking can delay healing. Talk with your provider if you need help to stop smoking.

Before your surgery, you may need imaging tests. These may include ultrasound, X-rays, or MRI.

Don't eat or drink after midnight the night before your surgery. Tell your provider about any recent changes in your health, such as a fever.

You may need to plan some changes at home to help you recover. This is because you won’t be able to walk on your foot normally for a while. Plan to have someone drive you home from the hospital.

What happens during Achilles tendon repair surgery?

Achilles tendon surgery can be done with several methods. The surgery is done by an orthopedic surgeon and a team of specialized healthcare providers. Ask your surgeon about the details of your surgery. The surgery may take a couple of hours. During your surgery:

  • You may have spinal anesthesia. This is so you won’t feel anything from your waist down. You’ll also likely be given sedation. This will help you sleep through the surgery.

  • A provider will watch your vital signs, like your heart rate and blood pressure.

  • The surgeon will make an incision through the skin and muscle of your calf. If you have minimally invasive surgery, the surgeon will make several small incisions. They may then use a tiny camera with a light to help do the surgery.

  • Your surgeon will make an incision through the sheath that surrounds the tendon. They'll remove parts of your damaged tendon or repair the tear in the tendon.

  • Your surgeon may remove another tendon from your foot. This is then used to replace part or all of the Achilles tendon.

  • Your surgeon will make any other repairs that are needed.

  • The surgeon will close the layers of skin and muscle around your calf with sutures (stitches).

What happens after Achilles tendon repair surgery?

A healthcare provider will watch you for a few hours after your surgery. When you wake up, you'll likely have your ankle in a splint. This is to keep it from moving. Achilles tendon surgery is often an outpatient procedure. This means you can go home the same day.

You'll have some pain after your surgery, especially in the first few days. Pain medicines can help relieve your pain. Keep your leg elevated as often as possible. This can help reduce swelling and pain. Make sure to tell your healthcare provider right away if you have a high fever or pain in your ankle or calf that gets worse. After your surgery, you'll likely need to use crutches. This is so you can keep your weight off your leg.

About 10 to 14 days after your surgery, you’ll need to return to your provider to have your stitches removed. Your provider might replace your splint with a cast at this time. If so, follow all instructions about keeping your cast dry. Or your provider may give you a special removable boot instead of a cast.

Your provider will give you instructions about when you can put weight on your leg. They'll tell you how to strengthen your ankle and leg muscles as you recover. You may need to do physical therapy to help with your recovery. It can take up to 12 months of rehab before you're free of pain.

Make sure to follow all your provider’s instructions about medicines, wound care, and exercises. This will help make sure the surgery is a success for you.

Next steps

Before you agree to the test or procedure make sure you know:

  • The name of the test or procedure

  • The reason you are having the test or procedure

  • What results to expect and what they mean

  • The risks and benefits of the test or procedure

  • What the possible side effects or complications are

  • When and where you are to have the test or procedure

  • Who will do the test or procedure and what that person’s qualifications are

  • What would happen if you did not have the test or procedure

  • Any alternative tests or procedures to think about

  • When and how you will get the results

  • Who to call after the test or procedure if you have questions or problems

  • How much you will have to pay for the test or procedure

Medical Reviewers:

  • Rahul Banerjee MD
  • Raymond Turley Jr PA-C
  • Stacey Wojcik MBA BSN RN