Achilles tendon repair
The Achilles tendon is the largest tendon in the body and can be torn in a variety of settings. This is most common in the “weekend warrior” sportsman and is most common in explosive activities such as basketball.
Achilles tendon ruptures are typically confirmed clinically, but sometimes patients have ultrasound or MRI scans as well to confirm the diagnosis.
Surgical repair of the tendon provides the following potential benefits over non-operative treatment:
Surgery is done via a small incision over the rupture site and approximating the two tendon ends together, or in some ruptures by anchoring the tendon down to the calcaneus bone.
Figure 1: midsubstance suture repair achilles tendon
Figure 2: achilles repair with anchoring the tendon into the heel bone, necessary for some rupture types
Post-operative plan:
Surgery is typically a day case or overnight stay
Local anaesthetic is administered to help with pain
0-2 weeks: elevation at home, weight bearing in boot
2-8 weeks: weight bearing in boot with functional rehabilitation
8-10 weeks onwards: weaning out of boot and progressing to strengthening
12 weeks onwards: ongoing strengthening
Full return to function is typically achieved by 4-5 months post surgery
Download post operative care guide
Risks of surgery
Swelling, stiffness
Infection and wound breakdown
Blood clots – medication will be prescribed to prevent blood clots post operatively
Scar sensitivity
Re-rupture
Calf weakness
[1] Ochen Y, Beks RB, Van Heijl M, Hietbrink F, Leenen LPH, Van Der Velde D, et al. Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis. BMJ. 2019 Jan 7;k5120.
[2] Porter DA, Barnes AF, Rund AM, et al. Acute achilles tendon repair: strength outcomes after an acute bout of exercise in recreational athletes. Foot Ankle Int 2014;35(2):123-130.