Primary Repair of Achilles Tendon

Learn more about primary repair of Achilles tendon surgery at King Edward VII’s Hospital

Why would I need primary repair of Achilles tendon surgery?

The Achilles tendon is a large, strong tendon that connects the calf muscles to the heel bone.

Damage to the Achilles tendon is common in people who play sports such as football or racquet sports that require twisting or lunging movements or the need for the foot to push forcefully away from the floor. The Achilles tendon can also be damaged during slips and trips that quickly force the foot upwards. The Achilles tendon can either become fully or, less commonly, partially ruptured. When the Achilles tendon ruptures, you’ll feel immediate pain in your heel or calf, and you may hear an audible snapping or popping sound. You may notice some swelling or bruising and the pain may linger, become a dull ache or completely disappear.

Tendonitis, and the long term use of certain medicines including some steroids and antibiotics can weaken the Achilles tendon, causing it to rupture. It will be difficult to walk normally with a ruptured Achilles tendon and it may also be difficult to stand on tip toes or walk up stairs.

What symptoms does primary repair of Achilles tendon surgery address?

Surgery to repair the Achilles tendon can help to relieve the pain and inconvenience of a ruptured Achilles tendon, and allow for a better quality of life, especially in young, fit, moderately or very active people.

When should you speak to your specialist about primary repair of Achilles tendon surgery?

If you think you’ve torn your Achilles tendon, then speak to your specialist urgently. They may be able to suggest pain relief, physiotherapy or surgery to repair your Achilles tendon.

How is primary repair of Achilles tendon surgery performed?

Primary repair of Achilles tendon surgery is performed under a general anaesthetic. Generally, the surgery involves a surgeon making one straight or three smaller surgical incisions in the back of the ankle. This is a keyhole surgical technique, which causes minimal trauma to Achilles sheath and skin and has the lowest risks.

Using strong surgical stitches, the surgeon will then stitch the two ends of the ruptured tendon together before stitching up the surgical incision(s).

What is the recovery for primary repair of Achilles tendon surgery?

Your recovery from primary repair of Achilles tendon surgery will depend on multiple factors, including your age, fitness level and the nature of your procedure. After your surgery, you will need to wear a below knee cast/backslab and use crutches for a few weeks. You will also need to avoid putting any weight on your ankle during this time – your surgeon will advise you how long for.

The backslab will be changed at 2 weeks to an Aircast boot that you will have for 8-10 weeks. At 2 weeks you will need to see a physiotherapist who will guide you through some exercises that will strengthen your lower leg and improve your range of movement following surgery.

Your medical team will advise you how long you will need to take off work and how long after surgery you can begin playing sports and exercising again. As a general rule, most people need to take up to eight weeks off work and can return to jogging and non-contact sports after around six months.

Are there any risks/complications associated with primary repair of Achilles tendon surgery?

As with any medical procedure, it’s possible for risks or complications to arise. Speaking with your specialist or surgeon beforehand will help you avoid any adverse reactions.

Primary repair of Achilles tendon surgery has a relatively low risk of serious complications, but the following risks and complications can occur in a small number of cases:

• An infection in the wound
• Bleeding
• Re-rupture
• The development of scar tissue
• Nerve or blood vessel damage
• Numbness or weakness
• Delayed wound healing
• Blood clots leading to deep vein thrombosis (DVT)

How can I prepare for primary repair of Achilles tendon surgery?

Prior to surgery to repair a ruptured Achilles tendon, your surgeon will discuss with you how best to prepare for surgery, as each patient is different. Most of the time, an Achilles tendon repair needs to be performed as soon as possible so the usual advice for preparing for surgery (losing weight, being active and quitting smoking) isn’t as simple to follow. But taking steps to go into surgery as healthily is possible is advised.

Are there alternatives for primary repair of Achilles tendon surgery?

Sometimes, it’s possible to treat a ruptured Achilles tendon without surgery. This usually involves wearing a special cast and/or brace on your leg for several weeks to rest the tendon and allow it to heal naturally, alongside physiotherapy. This is usually better suited to someone who is elderly or inactive.