Achilles Tendon Repair

What is it?

The Achilles tendon is the long fibrous cord that connects the calf muscle to your heel. It may tear if it is overstretched, usually while playing sports. The tear may be partial or complete and most commonly occurs just above the calcaneus (your heel bone). A snap or crack sound may be heard at the time of injury. Pain and swelling near your heel and an inability to bend your foot downward or walk normally are signs that you may have ruptured your Achilles tendon.

What are the treatment options? Surgery is typically needed for a complete rupture, but some people non-surgical options work just as well. After surgery, your ankle will be kept stable in a cast or walking boot for up to 12 weeks. A torn ligament may also be managed nonsurgically with a below-knee cast, which would allow the ends of the torn tendon to heal on their own. This nonsurgical approach may take longer to heal, and there is a higher chance that the tendon could re-rupture. Surgery offers a better chance of full strength recovery and is often the treatment of choice for active people who wish to resume sports.

Procedure Goals

The goal of Achilles tendon repair is to reattach the torn tendon and restore calf function.

Risks of the Procedure

Patients undergoing any surgery are subject to risks of infection, wound healing problems, nerve injury, deep vein thrombosis and pulmonary embolism. Infection rates are reduced in surgeries that employ smaller incisions.

What to Expect

With Achilles repair, an incision is generally made on the back of your lower leg/calf and the tendon is stitched back together. Depending on the extent of the tear, the repair may be strengthened by using other tendons.

Before Procedure

The day of the procedure, you will need to arrange for a ride to and from the procedure and arrange for help at home

Wear shorts or loose pants and a t-shirt for surgery.

Do not eat or drink anything after midnight for arrivals before noon. Otherwise, do not eat or drink anything seven hours prior to your arrival at the surgery center.

If crutches or a walker are needed, please rent or borrow them prior to your surgery.

You will be contacted by Lawrence Surgery Center to set up your patient account. They will inform you of your pre-operative instructions as well as tell you when to arrive for surgery.

After Procedure

After Achilles tendon repair, you will most likely be placed in a cast for 2 weeks and then transition to a boot for an additional 2-6 weeks. You will be non-weightbearing for 4-6 weeks based on your surgeon’s protocol.

Discharge Instructions

Diet

You may resume your regular diet. However, start slow with clear liquids and gradually work your way back to your normal diet. This will help prevent nausea and vomiting.

Ankle Care & Bathing

Use your crutches and do not place any weight on your operated leg! This is important!
Keep your ankle elevated above heart level as much as possible for the first five days, then as needed when symptomatic for up to two weeks. This will prevent painful swelling and promote healing.
Keep your splint clean and dry all the time.
It is ok to shower or sponge bath two days after surgery but you must keep your splint clean and dry at all cost! This usually entails wrapping your ankle in a plastic garbage bag to keep it dry.

Cold Therapy

To help reduce pain and swelling, apply an ice pack to the surgical area for 20 to 25 minutes every one to two hours for the first 48-96 hours and then as needed to help control pain and swelling.
To avoid frostbite, place a towel or t-shirt between the ice pack and your skin.
It is not necessary to use ice while sleeping.
We recommend the use of a cold therapy unit, which is often an out of pocket expense. The advantage of this unit is that the temperature can be regulated, allowing for continuous use for several hours at a time.

Pain Medication

Your physician will give you a written prescription for pain medicine as you leave the surgery center. Take your pain medication as prescribed. You may want to take it regularly for the first 48 hours after surgery. Do not take any additional Tylenol.
While you are asleep in the operating room, a long acting numbing medication may be injected into the surgical area to help relieve your immediate postoperative discomfort for up to 24 hours. When you first notice tingling or throbbing, begin taking your pain medicine so it will become effective before the local anesthesia wears off.
No driving while taking any narcotic pain medication!
The pain medication may cause some nausea so take it with food.
The pain medication and general anesthesia may also cause constipation, so you may need to take a stool softener, fiber bar, Metamucil or prune juice to prevent constipation.

Follow-up Care

Watch for temperature > 101.5F, persistent numbness and tingling in the foot, persistent bleeding or drainage from the wound, foul odor, progressively worsening pain that is unresponsive to pain medication, blue toes, chest pain or difficulty breathing. If you have any of these symptoms, call the office if during normal business hours or go to the nearest emergency room.
If you do not have a postoperative appointment set-up already, please call the office to schedule an appointment for 7-10 days after surgery at (785)843-9125.

Rehabilitation Plan - Exercises

Whether surgical or nonsurgical, you'll go through a rehabilitation program involving physical therapy to restore range of motion, strengthen your leg muscles and Achilles tendon, and return you to your previous level of activity. Most people are able to return to all activities within six to twelve months.