The Achilles tendon is the large, thick tendon connecting your calf muscles to your heel. Achilles tendonitis happens when this tendon gets inflamed and irritated, often caused by overuse. Achilles tendon rupture happens when the tendon tears slightly or completely, typically during sports.

When other treatments aren’t helping your Achilles tendon injury enough, the foot and ankle team at OHSU can do surgery.

Achilles tendon repair surgeries:

• Can repair Achilles tendons that break completely or tear, usually due to athletic activity, or have chronic damage from tendonitis
• Can improve how you move and how well your foot and ankle function

What are Achilles tendon repair surgeries?

Achilles tendon repair surgeries are treatments for acute Achilles tendon rupture and chronic Achilles tendonitis.

Our team provides two categories of Achilles tendon repair surgeries:

• Achilles tendon rupture repair surgery repairs a tear in the Achilles tendon or reconnects the two parts of the severed tendon.
• Achilles tendonitis surgery treats the tendon when it has been damaged by overuse.

When are Achilles tendon repair surgeries recommended?

Your doctor might recommend surgery if other treatments, like physical therapy or injections, aren’t improving your symptoms enough.

How Achilles tendon repair surgeries work

The goal of these surgeries is to improve movement, strength, and foot and ankle function.

Achilles tendon rupture surgery

In Achilles tendon rupture surgery, your doctor makes a small cut (incision) to reach the tear in your tendon. Then, they connect the two broken or torn ends of the Achilles tendon to each other. Sometimes, they might use tendon tissue from another part of your body to repair the Achilles.

Achilles tendonitis surgery

This surgery may include lengthening the fascia on top of the calf muscles to decrease pressure on parts of the tendon thickened by tendonitis. Or your surgeon might remove scar tissue on the tendon and small bits of bone growth that have developed because of chronic inflammation. To do this, the surgeon may peel the tendon away from where it inserts to remove the unneeded tissue. The surgeon would then reattach the tendon and close the wound.

How long do Achilles tendon repair surgeries take?

Both types of Achilles tendon repair surgery take one to two hours.

How to prepare for Achilles tendon repair surgeries

Before surgery: Your care team will give you detailed instructions to help you prepare for surgery. You will also meet with the Pre-Operative Medicine Clinic and with a physical therapist.

Driving home: You will need somebody to drive you home.

Medications: If you take blood thinners, you should stop them before surgery. You may also need to stop medicines that suppress your immune system. Your care team will review that with you.

Achilles tendon repair surgeries recovery

Your care team will talk to you about what you can expect as you recover from surgery.

Pain: Achilles tendon repair surgeries can be painful. You may have swelling and pain after the pain medicine you got during surgery wears off. You will most likely get pain medicine when you go home.

Swelling: You might have a lot of swelling in the first two weeks after surgery. If you can, take time off work to rest at home and keep your foot elevated.

Follow-up appointments: You will have a follow-up appointment after two or three weeks to remove your stitches.  You may have another one after six weeks for imaging tests. You may also see a physical therapist to stretch and strengthen the area.

If your job is not physically demanding, you can likely return to your regular activities in 3 to 4 weeks. If your job is physically demanding, you will probably need to take a few months off.