The achilles tendon connects the muscles in the back of the calf (lower leg) to the heel bone. If it is overextended, it can tear (rupture), either partially or completely. Achilles tendon rupture is an injury most commonly found in people playing recreational sports, especially those involving explosive acceleration or jumping. It may also occur as a result of falling onto one's feet or stepping into a hole.
Two types of surgery may be performed to repair a ruptured achilles tendon: 1) open surgery, where a surgeon makes a single large incision in the back of the leg, and 2) percutaneous surgery, where a surgeon makes several small incisions rather than one large one. In both types, the surgeon stitches the torn tendon back together through the incision(s). Depending on the condition of the torn tissue, the repair may be reinforced with other tendons (such as the tendon of plantaris or another vestigial muscle), or the surgeon may use a reinforcement mesh (collagen, Artelon or another degradable material). For sedentary patients and those who have vasculopathy or risks for poor healing, percutaneous surgical repair may be a better treatment choice than open surgical repair.
After either type of surgery, a patient will likely wear a cast, walking boot, or similar device for 6 to 12 weeks. Surgery may be delayed for about a week after the rupture to allow for swelling to go down.