Achilles
tendon surgery is done when the Achilles tendon in the
back of the heel is torn in two. Achilles tendon surgery
is the best way to prevent the Achilles tendon from
tearing again. Surgery works much better than simple
casing and recovery time from surgery is less than with
casting. Achilles tendon surgery involves cutting into
the leg, near the heel, repairing the torn tendon and
sewing up the incision. Achilles tendon surgery must be
done from one week to six weeks following injury. After
six weeks, the surgery may not work as well as it would
have if done earlier. Often, the surgeon will wait one
week after getting a torn Achilles tendon in order to do
the surgery so that the swelling will have a chance to
subside.
When Achilles tendon surgery is complete, the physician
will place either a cast or a boot on the foot in
downward-pointed position son that the tendon can heel.
The boot or cast must then gradually be adjusted until
the foot is in a natural position. The doctor will also
have the patient do some small restricted motion
exercises after Achilles tendon surgery in order to
decrease the time needed for healing and rehabilitation.
Rehabilitation following Achilles tendon surgery may
take several months before the tendon is strong enough
to return to normal activities.
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Achilles tendon surgery
is successful about seventy percent of the time. The
definition of successful in this instance is that the
patient is able to resume the sports activities that he
or she was doing before the injury. Some stiffness may
be present after Achilles tendon surgery but this is
still considered successful. The sooner following injury
the Achilles tendon surgery is done, the better chances
for success.
Successful Achilles tendon surgery depends on various
factors such as how experienced the doctor performing
the surgery is, how damaged the tendon is, the length of
time after injury that the surgery is done, what type of
procedure the doctor uses, and how well the patient
follows recommended rehabilitation techniques after
Achilles tendon surgery. Before going through with
Achilles tendon surgery, check whether your doctor is
experienced in the technique and how successful his
previous surgeries have been.
There are two types of Achilles tendon surgery to choose
from. One is open surgery, where an incision is placed
in the back of the leg and the tendon is then stitched
back together. The other is called Percutaneous Achilles
tendon surgery. This involves using several small
incisions instead of one large one.
Percutaneous Achilles
tendon surgery should only be done within one week
following injury. Percutaneous Achilles tendon surgery
used to be not as effective as open surgery but now,
with recent advances, it is just as effective and has
fewer complications than in the past. The advantage of
Percutaneous Achilles tendon surgery over open achilles
tendon surgery is that Percutaneous Achilles tendon
surgery has less of a chance for wound healing problems
than open sugery.
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Open Achilles tendon
surgery has the lowest rupture rate following surgery
(2.7%) followed by Percutaneous Achilles tendon surgery
(6.4%) and casting or splinting (12%). The disadvantage
of using Percutaneous Achilles tendon surgery is that it
may cause an entrapped sural nerve which may lead to
additional surgery to repair. Recently, however, the
rate for this problem has gone down so much that the
chances of nerve damage happening with Percutaneous
Achilles tendon surgery is practically nil.
Like in any surgery, there are some risks involved in
Achilles tendon surgery. Risks include nerve damage,
bleeding, medication side effects, skin infections at
the site of incision, decreased range of motion, less
strength in the injured Achilles tendon than before
surgery, and the risk of another rupture following
surgery (0%-4%).
If you have suffered a torn Achilles tendon, it is
important to see your doctor right away. You should
discuss whether surgery is right for you, check to find
an experienced and successful surgeon, and follow
whatever rehabilitation program that is recommended
following surgery.
Achilles tendon surgery can be quite successful, with a
shorter healing time than simple casting and a decreased
chance for re-rupture of the Achilles tendon. You should
discuss with your doctor the risks of Achilles tendon
surgery verses the benefits in order to decide if
Achilles tendon surgery is right for you. Remember that
is important not to delay, because the sooner after
rupture that you get the surgery, the better chance for
success.
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