Treatments

Achilles Tendon Rupture Repair

Achilles tendon rupture surgery aims to restore the connection between the calf muscles and the heel bone, thereby reinstating push-off strength essential for walking. The procedure is crucial for individuals wishing to resume activities such as jogging, biking, or sports after experiencing an acute or chronic Achilles tendon tear.

Candidate Selection

Those best suited for surgical intervention are typically healthy, active individuals eager to return to physical activities. However, even less active individuals may opt for surgery, although non-surgical treatments are also available. Factors such as infection, unhealthy skin around the rupture site, or general health conditions like diabetes or smoking may influence the decision-making process. Consultation with a foot and ankle orthopedic surgeon is crucial in determining candidacy.

Treatment Procedure

Surgical repair of an Achilles tendon rupture is usually conducted on an outpatient basis, allowing patients to return home the same day. A nerve block is administered to alleviate postoperative pain, followed by anesthesia induction. The surgeon accesses the ruptured tendon, with repair typically lasting between 30 minutes to an hour for acute ruptures and longer for chronic cases. Various techniques may be employed, with open repair being the most common, involving suturing the tendon ends together.

Recovery Process

Post-surgery, patients are immobilized with a splint or cast and are advised against weight-bearing on the affected leg. Crutches, walkers, or wheelchairs aid mobility, while elevation helps reduce swelling and discomfort. Follow-up appointments are scheduled for wound evaluation and potential suture/staple removal. Depending on the patient’s condition, gradual weight-bearing and ankle motion may be initiated, typically transitioning to full weight-bearing around four to six weeks. Physical therapy facilitates ankle range of motion restoration and muscle strengthening, with full activity often achievable within six months to a year post-surgery.

Risks and Complications

As with any surgery, risks include anesthesia-related complications, infection, nerve or blood vessel damage, and bleeding or blood clots. Achilles tendon surgery-specific complications may include wound infection, delayed healing, re-rupture, or nerve damage leading to numbness or burning sensations.

Understanding the intricacies of Achilles tendon rupture surgery aids in informed decision-making and postoperative management, ensuring optimal recovery and long-term outcomes.

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Frequently Asked Questions

Will I be able to return to my previous level of activity after surgery?

Surgical repair of acute ruptures generally yields positive outcomes, though the affected leg may not fully regain pre-injury strength.

How can I prevent future Achilles tendon injuries after surgery?

To reduce the risk of future Achilles tendon injuries, it's important to maintain a strong and flexible lower extremity, wear appropriate footwear, warm up properly before exercise, and gradually increase the intensity and duration of physical activity. Additionally, avoiding sudden changes in activity level or overtraining can help prevent re-injury.

What is the risk of re-rupture after surgery?

The risk of re-rupture post-surgery is minimal, estimated at less than 5%. In cases of re-rupture, revision surgery, which is more complex, may be required, utilizing alternative techniques to reinforce the repair.

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