Achilles tendon rupture should i have surgery

How well do treatments work? The success of your surgery depends on: Your surgeon's experience. The type of surgery you have percutaneous or open surgery. How badly your tendon is damaged. How soon after the rupture your surgery is done. How soon your rehabilitation rehab program starts after surgery. How well you follow your rehab program.

What are the risks of surgery? A review of small studies of surgeries done within 3 weeks of an Achilles tendon rupture showed: Among people who have surgery, up to 5 out of may have another rupture after surgery. Up to 18 out of people who had open surgery had an infection, and there were no infections after percutaneous surgery. Infection is possible with any surgery, but it is more common with open surgery. The small risk of other complications was about the same with either open or percutaneous surgery, and most problems go away over time.

These complications included pain, delayed wound healing, nerve damage, and problems with scarring. What are the risks of immobilization? Why might your doctor recommend surgery for a ruptured Achilles tendon? Your doctor may advise you to have surgery if: You are physically active in sports, at work, or at home. You have a job that requires leg strength.

Compare your options. Compare Option 1 Have surgery for Achilles tendon rupture Treat the rupture with a cast or brace immobilization. Compare Option 2 Have surgery for Achilles tendon rupture Treat the rupture with a cast or brace immobilization. Have surgery for Achilles tendon rupture Have surgery for Achilles tendon rupture You will most likely go home the same day as surgery. You will spend 6 to 12 weeks after surgery wearing a walking cast or boot. If you sit at work, you can go back in 1 to 2 weeks.

If you're on your feet at work, you may need 6 to 8 weeks before you can go back. Your total recovery time can be up to 6 months. Surgery repairs the tendon and makes another rupture less likely. You can go back to work and resume daily activities sooner than with immobilization.

All surgery has risks, including bleeding and infection. Your age and your health can also increase your risk. You may have: Minor pain and temporary nerve damage. Slight risk of deep vein thrombosis or permanent nerve damage. A small risk of repeat tendon rupture. Treat the rupture with a cast or brace immobilization Treat the rupture with a cast or brace immobilization You'll wear a cast, splint, brace, walking boot, or other device for several months.

Immobilization allows you to avoid surgery and the risk of wound infection. You may have: Repeat tendon rupture. Loss of strength in the leg. Minor pain and temporary nerve damage. A very slight risk of deep vein thrombosis or permanent nerve damage.

Personal stories about surgery for Achilles tendon rupture These stories are based on information gathered from health professionals and consumers. What matters most to you? Reasons to choose surgery for a ruptured Achilles tendon Reasons to choose a cast or brace immobilization to treat a ruptured Achilles tendon. I don't want to risk having another tendon rupture. My job requires that I have strong legs. My job doesn't require that I have strong legs. I'm not worried about the risks of surgery.

I'm worried about the risks of surgery. I'm an active person, and I want to stay active. The cast or boot is then adjusted gradually to put the foot in a neutral position not pointing up or down.

Many health professionals recommend starting movement and weight-bearing exercises early, before the cast or boot comes off. Your total recovery time will probably be as long as 6 months. This surgery is done to repair an Achilles tendon that has been torn into two pieces. Both open and percutaneous surgeries are successful.

More than 80 out of people who have surgery for an Achilles tendon rupture are able to return to all the activities they did before the injury, including returning to sports. It's sometimes hard to know how surgeries compare. That's because the ages and activities of people having the surgeries differ.

The success of your surgery can depend on:. Talk to your surgeon about his or her surgical experience and success rate with the technique that would best treat your condition. The risks of Achilles tendon surgery include:. Infection is possible with any surgery, but it may be more common with open surgery than with percutaneous surgery.

The small risk of other complications is about the same with either open or percutaneous surgery. All professional footballers will be managed with an operation to bring the two ends of the tendon together. The average time for these footballers to return to sport after a ruptured Achilles is just over 7 months. So why do all footballers have the operation but not everyone?

There are many factors to consider, which will be outlined in this article. A decade ago, surgical treatment was often favoured for an Achilles rupture due to the concerns related to re-rupture rate with conservative non-operative management. Kahn et al. It is important to acknowledge the difference was reported in studies that emphasised traditional immobilisation methods in the conservative method.

This means immobilisation with non-weightbearing in a plaster cast for at least six weeks, followed by activity and physiotherapy. Certainly, the re-rupture rate for non-operative management can be lower when there are early functional rehabilitation protocols. We will discuss this more later. However, more recently in the last 10 years particularly , there have been many large, well-controlled, randomised controlled studies that have shown the same results for surgical versus conservative non-surgical management.

As a result, there has been a shift away from surgical management. The incidence of operations following an Achilles rupture has reduced over the past decade as a result of many high-quality trials showing comparable results between. It is worth noting that in elite sport the trend is still to operate as previous studies have demonstrated these athletes return to full capacity faster than those treated with non-surgical options.

More recent research does not support this claim. Surgical repair of an Achilles rupture uses either an open, a mini open or a minimally invasive surgical MIS approach. This reflects how big the incision is; an open operation has the largest incision and therefore scar, but provides the best visualisation of the tendon for the surgeon.

It is unknown what provides the best repair. There are multiple randomised control trials which have compared the three methods but have shown conflicting results regarding superiority and complications. The review by McMahon et al. The major difference in MIS is a lower rate of superficial infections compared with open repair.

Superficial infections effect the skin and do not cause any long term issues, but can be uncomfortable, inconvenient and can delay your rehabilitation. Interestingly, those treated with MIS were approximately three times more likely to report a good or excellent result. When assessing the mechanical properties of the repair, Clanton et al. With cyclic loads the MIS tendons were more likely to elongate i.

However, the ultimate failure point i. The authors concluded the MIS tendon may need a longer period of protection post- surgery; however, this is unlikely to delay recovery. The American Academy of Orthopaedic Surgeons AAOS recommends that surgical repair should be carefully considered in diabetics, smokers, those over 65 years old, the sedentary, the obese and those with a concern surrounding wound healing. Both methods are complimented by formal physiotherapy to restore full function.

At Complete Physio the majority of our patients are managed this way. However, functional bracing using a walking boot with wedges, to gradually reduce the amount of plantarflexion i.

Furthermore, patients who immediately started fully weight bearing i. Surgery is advised for many cases of a ruptured Achilles tendon. But in some cases, your healthcare provider may advise other treatments first. These may include pain medicine, or a temporary cast to prevent your leg from moving.

And your healthcare provider may not advise surgery if you have certain medical conditions. These include diabetes and neuropathy in your legs. Or you may need Achilles tendon repair surgery if you have tendinopathy. But in most cases, other treatments can be used to treat tendinopathy. These include resting your foot, using ice and pain medicines, and using a brace or other device to stop your foot from moving.

Physical therapy can also help. If you still have symptoms after several months, your healthcare provider might advise surgery. Depending on the type of problem you have, Achilles tendon surgery might work for you. Talk with your healthcare provider about the risks and benefits of your choices. Your own risks may vary according to your age, the shape of your foot and leg muscles and tendons, your general health, and the type of surgery done. Talk to your healthcare provider about any concerns you have.

He or she can tell you the risks that most apply to you. Talk with your healthcare provider how to prepare for your surgery. Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines such as aspirin. You may need to stop taking some medicines ahead of time, such as blood thinners. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.

Before your surgery, you may need imaging tests. These may include ultrasound, X-rays, or magnetic resonance imaging MRI. Do not eat or drink after midnight the night before your surgery.