Surgery usually isn't needed to treat Achilles tendinopathy. But in rare cases, someone might consider surgery when rubbing between the tendon and the tissue covering the tendon (tendon sheath) causes the sheath to become thick and fibrous. Surgery can be done to remove the fibrous tissue and repair any small tendon tears. This may also help prevent an Achilles tendon rupture.
Achilles tendon rupture
Surgery is often used to reattach the ends of a ruptured Achilles tendon. It may provide a better chance of preventing the tendon from rupturing again compared to using a cast or other device that will keep your lower leg and ankle from moving (immobilization).1
Surgery works best when you have surgery soon after your injury. Recovering from surgery may take months. Most surgeons will wait a few days for swelling to go down, then do the surgery as soon as possible. Surgery is usually done within 4 to 6 weeks. You will also need a rehabilitation (rehab) program to help heal and strengthen the tendon.
Surgery for an Achilles tendon rupture can be done with a single large incision, which is called open surgery. Or it can be done with several small incisions. This is called percutaneous surgery.
What to think about
The differences in age and activity levels of people who get surgery can make it hard to know if Achilles tendon surgery is effective. The success of your surgery can depend on:
- Your surgeon's experience.
- The type of surgery you have.
- How damaged the tendon is.
- How soon after rupture the surgery is done.
- How soon you start your rehab program after surgery.
- How well you follow your rehab program.
Talk to your surgeon about his or her surgical experience. Ask about his or her success rate with the technique that would best treat your condition.