Candidates for Achilles tendon repair tend to be healthy, active people who want to return to activities such as jogging, running, and biking. Candidates should be sure they wish to proceed with a surgical option after exhausting non-operative treatment options.
Candidates who have not yet exhausted nonsurgical treatment options or who are suffering from an active infection at the site of the Achilles tendon rupture are generally are not good candidates for Achilles tendon repair. Patients with other conditions, such as obesity, a sedentary lifestyle, steroid use, or ineligibility for general surgery may also want to avoid Achilles tendon repair, as the risk profile of the procedure is higher in those cases.
Like other surgeries, Achilles tendon repair requires a complete physical examination with some kind of imaging (X-ray, MRI) of your affected ankle by your primary care provider and/or orthopedic surgeon before surgery. You should inform your orthopedic surgeon of any medications or supplements you take, and comply with certain general surgery protocol such as preoperative blood testing and possible cessation of smoking or use of pain relievers and anti-inflammatory drugs one week prior. You will likely be asked to stop eating or drinking the night before the surgery.
Immediately after your procedure, you will be in a splint or cast from the toes to below the knees, and should not put any weight on the involved leg. Your doctor will prescribe medication for pain relief, or maybe install a “pain pump,” which automatically dispenses medication for 1-3 days after the procedure. In the case of regional anesthesia (numbing the area between your neck and the end of your torso), you may feel a numbing sensation for 8-24 hours after the procedure. This is normal. You can expect to wear a cast or boot and may begin weightbearing on your affected ankle 2-6 weeks postoperative. After about 6 weeks, you will most likely be able to return to work and resume most normal activity, depending on the level of physical activity involved in your job. At this point, a formal physical therapy program (beginning a week after surgery) will also help you as you learn exercises to maintain a pain-free range of motion. Patients are generally able to return to normal activity fully by 6 months, and full recovery may take up to a year.
As with any surgery, there are risks of complications related to infection, damage to nerves and blood vessels, bleeding and blood clots, or adverse reactions to anesthesia. Other known complications include delayed wound healing, re-rupture of the Achilles tendon, scarring in the tendon, and thickening of the surgical scar.