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What is Achilles Tendon Reconstruction?
Achilles tendon reconstruction is a surgical procedure performed to repair or rebuild a severely damaged or ruptured Achilles tendon (the strong tendon at the back of the ankle that connects the calf muscles to the heel bone), especially when the tendon is not repairable by simple stitching or when previous repair has failed. It is most often used in cases of chronic Achilles tendon rupture, large tendon defects, or degenerative tendon disease.
What are the Indications for Achilles Tendon Reconstruction?
Achilles tendon reconstruction is usually indicated when the tendon is too damaged to heal with simple repair. This includes cases of chronic or neglected ruptures where the injury is diagnosed late, large tendon gaps that cannot be closed directly, and severe degeneration caused by long-standing tendinopathy. It is also recommended after a failed previous Achilles tendon repair or when there is significant loss of ankle function, such as difficulty pushing off the foot, standing on tiptoes, or walking normally.
What Does the Procedure for Achilles Tendon Reconstruction Involve?
The procedure for Achilles tendon reconstruction involves rebuilding the damaged tendon to restore strength and function. It is usually performed under regional or general anesthesia. The surgeon makes an incision at the back of the ankle to expose the tendon. If the tendon ends can be brought together, they are stitched directly. For large gaps or poor-quality tissue, additional techniques are used, such as transferring another tendon (commonly the flexor hallucis longus) to reinforce or replace the Achilles tendon, or using grafts (from the patient or a donor) to bridge the defect. In some cases, synthetic grafts or augmentation devices are used for extra support. Once the reconstruction is complete, the tendon and surrounding tissues are carefully closed, and the ankle is immobilized in a cast or boot to allow healing.
What Does Postoperative Care for Achilles Tendon Reconstruction Involve?
Postoperative care for Achilles tendon reconstruction involves protecting the repaired tendon and gradually restoring mobility and strength. Initially, the ankle is immobilized in a cast or boot, and patients are advised to keep weight off the foot using crutches. As healing progresses, partial and then full weight-bearing is introduced under guidance. Physical therapy plays a key role, focusing on gentle range-of-motion exercises, followed by strengthening and balance training. Pain and swelling are managed with medications, elevation, and ice. Strict adherence to rehabilitation is essential, as recovery is gradual and can take several months before normal walking, sports, or high-impact activities are safely resumed.
What are the Risks and Complications of Achilles Tendon Reconstruction?
Risks and complications of Achilles tendon reconstruction include the following:
- Infection
- Wound healing problems
- Nerve injury (numbness or tingling)
- Blood clots
- Re-rupture of the tendon
- Weakness or stiffness in the ankle
- Reduced range of motion
- Graft or tendon transfer failure
If you wish to be advised on the most appropriate treatment, please call to schedule an appointment or click to request an appointment online.
