How Doctors Decide to Treat a Ruptured Achilles

Your health and activity level influence recommendation for or against surgery

By Robert Preidt

Saturday, March 25, 2017

SATURDAY, March 25, 2017 (HealthDay News) -- Whether your doctor recommends surgery for a ruptured Achilles tendon may depend partly on your age and activity level, foot experts say.

The Achilles tendon is a band of tissue that runs down the back of the lower leg and connects the calf muscle to the heel bone. A rupture is a complete or partial tear of the tendon that leaves the heel bone separated or partially separated from the knee.

Length of recovery from this type of injury varies depending on whether a patient undergoes surgical or nonsurgical treatment.

"Treatment processes are dependent upon a patient's overall health, activity level and ability to follow a functional rehabilitation protocol," said Dr. Jeffrey McAlister, a foot and ankle surgeon in Sun City West, Ariz.

Advances in treating Achilles tendon rupture were discussed by McAlister and other specialists at a recent meeting of the American College of Foot and Ankle Surgeons, in Las Vegas.

Typically, less active and unhealthy patients receive nonsurgical treatment, since they are not trying to return to active sports, McAlister said in a college news release. But this approach usually involves a long rehabilitation/recovery period (9-12 months). Also, these patients may be at increased risk of potentially dangerous blood clots due to inactivity during this period.

"For more athletic and younger patients, the surgical option may be best," said Dr. Michael VanPelt, a Dallas foot and ankle surgeon. "We anticipate these patients have shorter healing times."

But because there is low blood flow to the Achilles tendon, healing after surgery can be tricky.

"Advances in surgical techniques to repair Achilles tendon ruptures include limited incision, or smaller incision, surgical approaches to help patients have smaller scars, and less of a chance of wound complications," said Dr. Jason Kayce, a Phoenix foot and ankle surgeon.

SOURCE: American College of Foot and Ankle Surgeons, news release, March 2017

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