In open surgery, the surgeon makes a single
large incision in the back of the leg.
In percutaneous surgery,
the surgeon makes several small incisions rather than one large incision.
In both types of surgery, the surgeon sews the tendon back
together through the incision(s). Surgery may be delayed for about a week after
the rupture, to let the swelling go down.
What To Expect After Surgery
After either type of surgery, you will likely
wear a cast, walking boot, or similar device for 6 to 12 weeks. At first, the
cast or boot is positioned to keep the foot pointed downward as the tendon
heals. 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.
Why It Is Done
This surgery is done to repair an
Achilles tendon that has been torn into two pieces.
How Well It Works
Both open and percutaneous surgeries are
successful. More than 80 out of 100 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.footnote 1
It is sometimes difficult to know how surgeries compare, because the ages and activities of those having the
surgeries differ. The success of your surgery can depend on your surgeon's experience,
the type of surgical procedure used, the extent of tendon damage, how soon
after rupture the surgery is done, and how soon your
rehabilitation program starts after surgery and how
well you follow it.
Talk to your surgeon about his or her
surgical experience and success rate with the technique that would best treat
The risks of Achilles tendon surgery include:
Skin infection at the incision
Normal complications of surgery or
anesthesia, such as bleeding and side effects from
Risk of repeat Achilles
rupture. This risk, though, is typically less than the risk after nonsurgical
The possibility that the healed tendon will not be as
strong as before the injury.
Decreased range of motion.
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. And most problems go away over time. These complications include pain, delayed wound healing, nerve damage, and problems with scarring.
What To Think About
An Achilles tendon rupture is
usually treated with surgery or with a cast, splint, brace, or other device
that will keep your lower leg and ankle from moving (immobilization).
Compared to immobilization, surgery provides a shorter recovery period and a reduced risk that the tendon will rupture again. There is
greater risk for wound complications in surgery, though.
Khan RJK, Smith RLC (2010). Surgical interventions for treating acute Achilles tendon ruptures. Cochrane Database of Systematic Reviews (9).
ByHealthwise Staff Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine E. Gregory Thompson, MD - Internal Medicine Specialist Medical ReviewerDavid Bardana, MD, FRCSC - Orthopedic Surgery, Sports Medicine