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Achilles Tendon Repair Surgery: All You Need to Know


The Achilles tendon is a thick, fibrous band of connective tissue that attaches the muscles at the back of the leg to the heel bone. It is the thickest and strongest tendon in the body, capable of bearing high tensile loads and supporting most of the body’s weight. 

The primary function of an Achilles tendon is to facilitate movement and to support concentrated stress. Despite its immense strength, the Achilles tendon is still vulnerable to several injuries that can tear and separate its muscle fibers, causing extreme pain and mobility problems.

Unfortunately, most tendon ruptures cannot heal on their own without surgical help. So, if you’re currently having the same medical issue, then there’s a considerable chance that your orthopedic doctor has already scheduled you for an Achilles tendon repair surgery.

Read on below to learn more about your upcoming procedure一how is it performed, when is it recommended, and how long will it take for you to recover.

What is Achilles tendon repair surgery?

An Achilles tendon repair is a surgical procedure to fix a damaged or ruptured Achilles tendon. It may also be used to mend re-tears in the newly restored Achilles tendon. Some of the most common causes of tendon injuries include the following:

  • Repetitive motion and stress or overuse of the tendons.
  • A violent or direct blow to the Achilles tendon, especially when a strong force is applied.
  • Sudden pivots and twists in the foot or ankle.
  • A traumatic accident, such as a car or motor collision.
  • An underlying injury or re-tear due to microfractures

Furthermore, the structure of the Achilles tendon may also get compromised as it gradually degenerates due to conditions such as tendonitis and tendinopathy.

When do you need Achilles tendon repair surgery?

Some cases of Achilles tendon injury (partial or mild tears) do not require surgical treatment. A doctor may decide to forgo surgery and stick to conservative approaches depending on the patient’s condition. This may apply to senior patients and those at risk for complications. 

Unfortunately, non-surgical treatment options only increase re-rupture, thus impeding recovery and healing. Additionally, medications and therapy won’t be enough for individuals with an active or vigorous lifestyle, such as competitive athletes or recreational activities enthusiasts.

Surgery is also the best and last option for individuals with ruptured tendons that do not get better with conservative approaches even after six months.

How is it performed?

An Achilles tendon repair surgery starts by administering spinal anesthetics and sedatives to the patient. A team of medical professionals will also be monitoring your vital signs during the procedure. Here are the next steps of the operation:

  • Your surgeon will create an incision through the skin and muscles on the back of the calf. The incision size will depend on whether your surgeon will perform open surgery or a minimally invasive technique.
  • Next, your surgeon will set aside the soft tissues to access the torn tendon. They will then remove the damaged parts, fix the ripped part, or attach the two ends using stitches. 
  • For severely damaged Achilles tendons, your surgeon may remove the whole connective tissue and replace it with a new tendon from another body part. 
  • Your surgeon may also repair other injuries in the ankle, such as microfractures.
  • Once done, your physician will close the incision using sutures and bandages.

After the procedure, you will be placed in a recovery area where you can rest while waiting for the anesthesia to wear off. Most patients get discharged a few hours after the surgery since an Achilles tendon repair is typically performed on an outpatient basis.

Frequently asked questions on Achilles tendon surgery

How long does the surgery take?

Most tendon repair surgeries only take about 30 minutes to an hour. Some may last for more than 2 hours but only for severe conditions and complex procedures, including tendon grafting.

How long do you have to stay off your foot after Achilles surgery?

When you wake up after the surgery, you’ll find your newly operated ankle in a cast or splint. 2 weeks after the surgery, your doctor may check or remove your stitches. They may also remove the cast off if necessary and put you on a walking boot. 

Your doctor will also recommend using crutches for 3 to 4 weeks to avoid putting weight and stress on the recovering leg. During this time, you’ll be required to take regular physical therapy sessions to establish muscle strength, proper movement, and pain relief.

Additionally, it is vital to attend your weekly or monthly check-ups so your doctor can evaluate your progress and advise when you can use your foot and return to your normal activities.

What not to do after Achilles surgery

Here are some of the most important post-surgical instructions you should follow for a fast and problem-free recovery:

  • Always keep your foot elevated when sleeping, especially during the first few days of recovery.
  • Do not put weight on the leg or perform activities unless cleared by your doctor.
  • Do not take a bath, shower, or swim unless your doctor says so. Make sure to follow their instructions regarding bathing.
  • Take antibiotics and pain medications as directed.
  • Follow doctors’ orders regarding incision and wound care to avoid infection.

How long does it take to walk after Achilles tendon surgery?

There’s no one-size-fits-all when it comes to the recovery timeline. But generally, patients will be required to put the newly operated ankle on a non-weight bearing cast immobilization for at least 3 to 4 weeks. This will be followed by two weeks in a walking boot and crutches.

The actual walking phase without any boot or crutches to help will begin eight weeks after the surgery. Full recovery, wherein the patient can return to normal, explosive activities, may be achieved after 20 weeks.

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ROSC is one of the leading outpatient surgery center in the Triangle. Our board-certified specialists have been treating and managing various orthopedic conditions for over ten years now. With our help, you can rest assured that you or your loved one will achieve maximum independence and full functionality through our highest quality of care.

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The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.