Achilles Tendon Repair

WHAT YOU SHOULD KNOW:

• Achilles (ah-KIL-ez) tendon (TEN-don) repair is surgery to fix your damaged Achilles tendon. Tendons connect muscles to bones, and together with muscles, work to move your arms, legs, fingers, feet, and toes. The Achilles tendon is located at the ankle, and connects the calf muscle to heel bone. Achilles tendon repair is done to reattach a ruptured (completely torn) Achilles tendon. This may be done using an open or a mini-open surgery. In a mini-open surgery, a special device is used without making a large incision (cut) in the ankle area. A complete tendon rupture may be acute or chronic based on the duration of time from injury. Injuries that occurred within three weeks are considered as acute, and after three weeks they are chronic. Chronic injuries can only be repaired using the open surgery.
  
  
• During surgery, caregivers repair the injured Achilles tendon by sewing the ruptured ends together. A tendon or fascia (hard tissue) graft may be used to strengthen the repair. The graft may be man-made, taken from another part of your body, or from a donor. It is used mostly in chronic tendon injuries. After surgery you may need a splint or cast to protect the tendon and help it heal. You may need to do special exercises to help build the strength back in your ankles. With repair of the Achilles tendon, your regular ankle and foot movements may be returned, and normal activities restored.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

There are always risks with surgery. You could get an infection or bleed too much. You could have trouble breathing or get blood clots. Other parts around the tendon, such as blood vessels and nerves may also be affected. Sometimes, even after surgery, the ankle may not go back to the way it was before. If you do not have surgery, the pain and problems you have when moving your ankle or foot may worsen. You may have problems walking, and may have trouble going back to your usual activities, including sports. Call your caregiver if you are worried or have questions about your injury, treatment, or care.

GETTING READY:

The week before surgery:

• Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.
  
  
• If you are female, tell your caregiver if you know or think you might be pregnant.
  
  
• You may have to meet with your physical therapist. This is the caregiver who will teach you special exercises to help your injured tendon heal faster. You may be taught how to use a brace and crutches.
  
  
• You may need to have blood tests, an electrocardiogram (ECG), chest x-ray, and other tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before surgery:

• Remove any nail polish.
  
  
• You may be given medicine to help you sleep.
  
  
• Ask caregivers about directions for eating and drinking.

The day of surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
  
  
• Do not wear tight-fitting clothes on the day of your procedure or surgery.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your surgery. Tell your caregiver if you or any member of your family has had a problem using anesthesia in the past.
  
  
• You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the surgery. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.

TREATMENT:

What will happen:

• You will be asked to change into a hospital gown. You may be given medicine to help you relax or make you drowsy. You will be taken on a stretcher to the room where your surgery will be done. Medicine called anesthesia will be given to keep you free from pain during the surgery. You will be placed on your stomach with your feet hanging at the end of the table. A tourniquet will be wrapped around your leg to help decrease blood loss. Your leg, ankle, and foot will be cleaned with soap and water and then covered with sheets.
  
  
• Caregivers will make an incision in your ankle area. If a mini-open surgery will be done, a device will be inserted in the incision to hold the tendon ends. Caregivers will reattach the torn tendon by sewing the ends back together. A graft or flap from the calf fascia may be used. This is done to strengthen the repair. The incisions will be closed with stitches and wrapped with a bandage. Your ankle will be put in a splint, cast, or brace so it will heal faster.

After surgery: You are taken to a room where you can rest. Caregivers will check on you. When they see that you are ready, you may also be allowed to go home. If you are staying in the hospital, you will be taken to your hospital room. Do not get out of bed until your caregiver says it is OK. A bandage is used to cover your stitches or staples. This bandage keeps the area clean and dry to help prevent infection. A caregiver may remove the bandage soon after your procedure or surgery to check the area.

Waiting room: This is a room where your family and friends can wait until you are ready for visitors. If your family leaves the hospital, ask them to leave a phone number where they can be reached.

CONTACT A CAREGIVER IF:

• You cannot make it to your surgery appointment on time.
  
  
• You have a fever (increased body temperature).
  
  
• You have a skin infection or a wound near the injured ankle.
  
  
• You have questions or concerns about your surgery.

SEEK CARE IMMEDIATELY IF:

• The problems for which you are having surgery get worse.
  
  
• You have a lot more pain or trouble moving around.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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