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What is Achilles tendon surgery?

Surgery is often used to repair a ruptured or torn Achilles tendon, 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. Achilles tendon ruptures are quite common. Most 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 Achilles tendon surgery until it subsides.

Types of treatment

There are two types of surgery that repairs 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 tendonitis (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 your Achilles 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.

What to expect

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.

Results

Success rates are high for both types of Achilles tendon surgery for a ruptured Achilles tendon. Research shows that more than 80 out of 100 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.

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