Achilles Tendon Rupture Repair

Achilles tendon rupture repair is carried out under a general anaesthetic, with an added injection around the area that numbs it after surgery to reduce pain.

What does it involve?

During the procedure the surgeon carefully reattaches the tendon ends with a strong stitch that dissolves naturally so will not need to be removed later on.

Recovery:

Immediately after surgery:

• Your foot will be in a plaster cast or a boot to the knee. It will be numb and pain-free
• You will be referred to a physiotherapist who will advise on walking while keeping weight off the ankle using crutches
• You will be sent home only when you are comfortable, with a follow-up appointment and painkillers if required

During the first few weeks:

• Elevate your foot (above the level of your heart) as much as possible to reduce swelling
• Move around only when you need to, for example to wash or use the toilet. Don’t put weight on the operated leg
• Some blood ooze can be expected in the bandage; however, if you are worried, contact the Fortius Clinic for advice
• Take painkillers as prescribed

Follow-up appointments

Everyone is different, so healing and post-operative programmes vary from person to person. However, the schedule of follow-up appointments below is typical:

• Two weeks - your wound will be checked and you may be given a special boot to support your foot
• 10 weeks - follow-up appointment once your foot is comfortably flat on the ground
• 20 weeks - return to full function

When can I start to walk?

Patients can respond differently to the surgery, with some being able to cope better than others with walking, especially in the early stages post-operatively. Below is a guide to what might typically be expected:

• 0-2 weeks - you will be in a plaster cast, with crutches to avoid bearing your weight
• Two weeks onwards - you will have a special supportive boot, take your weight if you are able to, with or without crutches and building up your strength slowly
• You will be referred to a physiotherapist who will be able to help with a rehabilitation programme of exercises

How do I wash and shower?

It’s important to keep the plaster cast totally dry. However, you can shower with a waterproof cover over the plaster. Once the plaster is removed you can shower as normal if the wound is healed, but gently dab it dry.

How should I look after the operation wound?

Once out of the cast, don’t pull at scabs but let them fall away naturally. If your wound becomes red, swollen or sore, contact the Fortius Clinic and arrange to see your consultant to check it’s not infected.

When can I start to drive again?

The DVLA states that it’s the responsibility of the driver to ensure they are always in control of the vehicle. A good guide is if you can stamp down hard with the foot to stop the car during an emergency stop. Being able to do this will usually take at least 10 weeks.

Although your specialist will advise you about when it’s safe to start driving again, it remains your responsibility to drive safely and you should also check with your vehicle insurer to confirm you are covered.

When can I return to work?

This depends on the type of work you do and how quickly you recover. As a general guide, if your job involves sitting down for most of the time, you should be able to return to work after four weeks; if it involves manual work, you may need to have 12-16 weeks off.

What long-term outcome can I expect after surgery?

You should recover a full range of movement to the ankle, with normal power and function, and be able to return to your usual sports activities. How long this takes can vary from person to person, but as a guide:

• Return to high level sports can take six to nine months
• Return to a more sedentary lifestyle can take four to six months
• The overall outcome is very good for most people, with over 90-95% being very happy with the results

What are the risks?

Below is a guide to the risks of this type of surgery. However, your surgeon will discuss these with you before your procedure and answer any questions you may have.

• Infection - Infection is quite rare (around 5%) but can be treated with antibiotics. Your specialist will discuss this with you before surgery
• Nerve damage - Small nerves that supply feeling to the skin near the operation site can be damaged although the risk of this is small (less than 5%). If your toe stays numb after surgery, it may be because the nerve is bruised, but this will usually recover
• Re-rupture - This can be caused by a further injury. If this happens, contact the Fortius Clinic as soon as possible as you will need urgent medical attention and possibly further surgery. Re-rupture occurs in between 2-5% of people but making sure you follow your rehabilitation plan can reduce the risk
• Deep Vein Thrombosis (DVT) - This is unusual after ankle replacement surgery, carrying a risk of only of 2-5%. However, you may be given blood-thinning medication after surgery as a precaution or if you are at higher risk

Important: This information is only a guideline to help you understand your treatment and what to expect. Everyone is different and your rehabilitation may be quicker or slower than other people’s. Please contact us for advice if you’re worried about any aspect of your health or recovery.