Achilles Tendon Surgery

Achilles tendon surgery

Achilles tendon surgery is often the preferred option for treating a torn achilles. If you are an active person or enjoy your sport then you will usually be advised to have surgery to repair your tendon. Here we outline the surgical options and post op rehabilitation.

Treatment options for a torn Achilles tendon

  • Achilles tendon surgery is a popular option for treating a torn achilles tendon. This is true for younger, more active patients.
  • However, although more recently non-operative treatment is being considered for all patients.

There are two types of Achilles tendon surgery currently available:

Open surgery

  • Here the surgeon makes a single large incision down the back of the calf allowing access for the tendon to be reattached.
  • This method is associated with a 27% lower risk of repeated rupture.
  • But there is an 11% risk of complications such as infection and adhesions.

Percutaneous Achilles tendon surgery

  • This involves several small incisions through which the Surgeon reattaches the tendon.
  • This technique has demonstrated higher re-rupture rates and a higher occurrence of nerve damage.
  • But there is a lower chance of resulting infection.

Post-Op

After Achilles tendon surgery the post-operative period varies between surgeons. A period of immobilization of 6-12 weeks has previously been favored.


Casts and walking boots

Usually, a cast or walking boot is provided to support your ankle and prevent movement. The cast is initially set to keep the ankle in a position of plantarflexion. This is the shortest position for the Achilles tendon, allowing it to heal with the least tension through it.

The cast is then gradually adjusted to bring the foot into a neutral position. Thie gradually lengthens the tendon giving it time to adapt.


Early mobilization

However, many Surgeons are now beginning mobilization a lot earlier (1-2 weeks) in order to prevent your tendon from becoming stiff and weak.

Movement helps to decrease swelling and orientation of the new tendon fibres being laid down as it heals. This results in higher tensile strength and therefore a reduced risk of re-injury later on.

Read more on Achilles rupture rehabilitation.


Rehabilitation after Achilles tendon surgery

  • Exercises begin with simply circling the ankle joint, increasing the size of the circles.
  • Stretches are then introduced, followed by strengthening with resistance bands.
  • Finally, weight-bearing exercises are commenced.
  • To give the patient confidence and reduce the strain on the Achilles tendon as rehabilitation progresses a simple Achilles taping technique can be used.
This article has been written with reference to the bibliography.