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Achilles tendon repair

Definition

Your Achilles tendon joins your calf muscle to your heel. You can tear your Achilles tendon if you land hard on your heel during sports, from a jump, accelerating when you are pushing off, or when stepping into a hole.

Surgery to repair the Achilles tendon is done if your Achilles tendon has a complete tear.

Alternative Names

Achilles tendon rupture - surgery; Percutaneous Achilles tendon rupture repair

Description

To fix your torn Achilles tendon, the surgeon will:

• Make a cut down the back of your heel
• Make several small cuts rather than one large cut

After that, the surgeon will:

• Bring the ends of your tendon together
• Sew the ends together
• Stitch the wound closed

Why the Procedure Is Performed

Before surgery is considered, you and your health care provider will talk about ways to take care of your Achilles tendon rupture.

You may need this surgery if your Achilles tendon has torn and separated.

You need your Achilles tendon to point your toes and push off your foot when walking. If your Achilles tendon is not fixed, you can have problems walking up stairs or rising up on your toes. However, studies have shown that Achilles tendon tears can sometimes be treated without surgery and have similar outcomes with surgical repair. Talk to your provider about which course of treatment is best for you.

Risks

Risks from anesthesia and surgery are:

• Breathing problems
• Reactions to medicines
• Bleeding or infection

Possible problems from Achilles tendon repair are:

• Damage to nerves in the foot
• Foot swelling
• Problems with blood flow to the foot
• Wound healing problems, which may require more surgeries
• Scaring of the Achilles tendon
• Blood clot or deep vein thrombosis
• Some loss of calf muscle strength

There is a small chance that your Achilles tendon could tear again. About 5 out of 100 people will have their Achilles tendon tear again.

Before the Procedure

Always tell your surgeon:

• If you could be pregnant
• What medicines you are taking, including medicines, herbs, or supplements you bought without a prescription
• If you have been drinking a lot of alcohol, more than 1 or 2 drinks a day

During the days before the surgery:

• You may be asked to stop taking aspirin, ibuprofen, naproxen, coumadin (Warfarin) , vitamin E,  and any other medicines that make it hard for your blood to clot several days before.
• Ask which medicines you should still take on the day of the surgery.
• If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see the provider who treats you for these conditions.
• If you smoke, try to stop. Ask your providers for help quitting smoking.
• Let your surgeon know about any illness you may have before this procedure. This includes COVID-19, a cold, flu, fever, herpes breakout, or other illness. If you do get sick, the procedure may need to be postponed.
• Ask your surgeon if you need to arrange to have someone drive you home after your surgery.
• You should elevate your ankle to decrease swelling.

On the day of the surgery:

• Follow instructions about when to stop eating and drinking.
• Take the medicines your surgeon told you to take with a small sip of water.
• Your surgeon will tell you when to arrive.

After the Procedure

Work with your surgeon to keep your pain in control. Your heel may be very sore.

You will be wearing a cast or splint for a period of time.

Many people can be discharged the same day of the surgery. Some people may require a short stay in the hospital.

Keep your leg elevated for as much as possible during the first 2 weeks to reduce swelling and promote wound healing.

Outlook (Prognosis)

You will be able to resume full activity in about 6 months. Expect full recovery to take about 9 months.

References

Azar FM. Traumatic disorders. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 48.

Irwin TA. Tendon injuries of the foot and ankle. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 118.

Jasko JJ, Brotzman SB, Giangarra CE. Achilles tendon rupture. In: Giangarra CE, Manske RC, eds. Clinical Orthopaedic Rehabilitation: A Team Approach. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 45.

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