The Achilles tendon runs at the back of the heel, providing structure and support for the actions of the lower leg and foot. Unfortunately, this tendon, the largest in the body, is also prone to becoming damaged or ruptured if it is overstretched or hit with a hard impact. In cases of a simple strain or inflammation, the Achilles tendon may heal itself over time, provided that the injured individual rests the affected foot. With a tear, however, healing may not be possible without a surgical procedure to repair the tendon.
Purpose
The purpose of an Achilles tendon repair is to fix a complete or partial tear of the Achilles tendon. Since an Achilles tendon rupture can cause intense pain and prevent normal everyday use of the foot and leg, the goal of surgery is to restore normal functioning. In athletes, the ultimate goal may be for the individual to be able to return to playing his chosen sport at the level he was previously participating.
Procedure
For surgery on an Achilles tendon, the doctor first makes an S-shaped incision on the back of the ankle. In some cases, the doctor may be able to use a small mini-incision instead of the larger S-shaped incision, but this is only possible within the first few weeks after the injury. A graft is placed between the two severed sections of tendon and the wound closed back up. The tissue slowly regrows onto the graft, repairing the tendon. The body gradually absorbs the original graft material so that only tendon tissue remains.
Risks
As with all surgeries, Achilles tendon repair carries some risks. Some people have a rare reaction to the anesthesia used. Blood loss, blood clots or additional damage to the foot and heel are other potential dangers. After the surgery, there is a possibility of infection developing in the wound. Proper wound care and observation can help prevent infection or catch any developing infection in an early stage so it can be treated before further complications develop.
After Care
After Achilles tendon repair, the patient should take pain medication prescribed by the doctor and follow his physician's instructions involving wound care. Some individuals will need to wear a brace, cast or splint to keep the ankle still while healing takes place. The doctor may also advise physical therapy before returning to normal activity after the Achilles tendon has healed.
Alternatives
In most cases, surgery to repair the Achilles tendon is a last resort and only recommended in cases where the tear is complete or nearly complete. A partial tear may be treatable using immobilization with a cast or brace, which allows the tendon to heal itself. Other Achilles tendon damage may be healed through rest and physical therapy.
