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Achilles Tendon Repair

Achilles tendon repair stitches a ruptured Achilles back together — the large tendon connecting the calf muscles to the heel bone. Most ruptures happen during a sudden push-off movement in sport. The torn ends are sutured through a small incision behind the ankle. Patients who have surgery tend to re-rupture less often and return to sport faster than those treated non-operatively.

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Achilles Tendon Repair surgery - orthopaedic procedure overview and what to expect

Who Needs Achilles Tendon Repair?

Surgery is generally right for active patients, younger people, and athletes who want the best chance of returning to high-level sport. Older or less active patients, and those with health conditions that raise surgical risk, can do well in a walking boot without surgery. Both work — your goals should drive the decision.

What to Expect

1
MRI or ultrasound confirms the rupture and gap between torn ends
2
Surgery takes 45-90 minutes under regional or general anesthesia
3
A 3-5 cm incision behind the ankle; the tendon ends are sutured together
4
Minimally invasive percutaneous techniques reduce incision size and wound complication risk
5
Cast or splint applied in equinus (toes pointed down) to protect the repair
6
Outpatient procedure — home same day

Recovery Timeline

Weeks 1-2

Non-weight-bearing in a splint. Keep the leg elevated. Focus on wound care.

Weeks 2-6

Transition to a walking boot. Protected weight bearing usually starts around weeks 2-4.

Months 2-3

Boot off around weeks 8-10. Physical therapy for range of motion and calf strengthening starts.

Months 3-5

Progressive calf strengthening. A jogging program can usually start around month 4-5.

Months 6-9

Most patients are back to sport. Full calf strength, though, takes 12 months or more.

Risks & Complications

  • Wound infection or healing problems (higher risk than most orthopaedic procedures due to thin skin behind ankle)
  • Sural nerve injury causing outer foot numbness
  • Re-rupture (2-5% after surgery vs. 10-15% without)
  • Deep vein thrombosis
  • Stiffness

Frequently Asked Questions

Should I have surgery or non-operative treatment for an Achilles rupture?

Both work. Surgery has lower re-rupture rates (2-5% vs. 10-15%) and tends to get athletes back to sport faster. Non-operative care in a boot avoids the wound complications that can occur with surgery behind the ankle. Active and younger patients lean toward surgery. Older or less active patients often do fine without it.

How long until I can run after Achilles repair?

A jogging program usually starts at 4-5 months. Return to competitive sport is typically 6-9 months out. Full calf strength can take 12 months or more — the Achilles is slow to rebuild its power, even after the tendon is healed.

What is the re-rupture rate after surgery?

Re-rupture rates after surgery run 2-5%, lower than non-operative management. Most happen in the first year. Sticking to the rehab protocol and not loading the tendon too aggressively early on are the best safeguards.

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Estimated Cost

$10,000 - $30,000 (before insurance). Covered by most insurance plans for acute ruptures.

Full cost breakdown

This information is for educational purposes only. Costs are estimates and vary by location, surgeon, and insurance. Always consult a qualified healthcare provider.