Achilles Conditions


NY Achilles Tendon Surgery

The Achilles tendon attaches the muscles of the calf to the calcaneus, or heel bone. When a force is applied that is too great for it to overcome, the Achilles may tear or rupture. It can often feel like something hit you in the back of the leg with no warning, or it may have been preceded by symptoms such as tendinitis or feeling that your muscles are tight or cramping. The event may cause you to fall or make it difficult for you to bear weight initially. You may also get a sense of weakness when trying to push off while walking or standing on your toes.

This diagnosis can often be made clinically through history and physical exam. Sometimes an MRI is useful to evaluate the integrity of the tendon. Not all Achilles tears/ruptures require surgery. Some may be treated conservatively depending on the extent of the injury, your activity level, and certain risk factors.

Located in New York, Dr. Levine is a foot and ankle orthopaedist that has vast experience in traumatology and reconstructive surgery.

Surgical Treatment

Achilles tendon repair surgery consists of cleaning the ends of the torn tendon and reattaching them by weaving a suture through it. Sometimes transfer of a tendon that runs nearby is recommended if the quality of the tendon is poor. This gives the tendon more strength and provides necessary blood flow for healing.

What to expect if you need surgery

If surgery is recommended, it is usually done as an outpatient so you are able to go home just hours after your surgery. You are placed in a splint for two weeks and strict elevation is recommended to maximize wound healing and limit your pain. Two weeks after surgery, we provide you with a removable boot to start therapy so that you can regain your mobility early. No weight bearing is allowed for six weeks post-operatively.

HSS is a hospital in New York that performs only orthopaedic surgeries. Therefore, we have a highly specialized group of physician assistants, nurses, and anesthesiologists that assist the surgeon during your surgery as well as during the post-operative period to ensure that you receive the best care.

If you live in New York and would like to learn more about Achilles injuries or surgical repair, please contact us today.

Additional Information on Achilles Tendon Injuries and Surgery

If you have severely injured your Achilles tendon, it is imperative that you find a New York foot and ankle surgeon as soon as possible. The Achilles tendon is very important to your mobility and should be treated by a foot and ankle specialist.

The Achilles tendon is the toughest and thickest tendon in the human body, attaching the gastrocnemius, soleus and also the plantaris to the calcaneus. It is approximately 15 centimeters (5.9 inches) long and begins near the middle section of the lower leg, or calf. Tightening of the gastrosoleus plantar flexes the foot and makes it possible for such activities as jumping, walking, and running. The Achilles tendon receives its blood supply from its musculotendinous attachment with the triceps surae and its innervation from the sural nerve, and to a lesser level from the tibial nerve.

People that generally rupture or tear their Achilles consist of leisure athletes or “weekend warriors”, individuals in their fourth or fifth decade of life, people with previous Achilles tendon tears or tendinitis, previous tendon injections or quinolone antibiotic use, those who engage in severe changes in training strength or activity level, as well as participation in new activities that their bodies are not used to.

If surgical treatment is recommended, an open repair is performed. With this technique, an incision is made in the back of the leg, where the Achilles tendon is sewn together. In a complete or major tear, the tendon of plantaris or another vestigial muscle mass is collected and twisted around the Achilles tendon, increasing the strength of the repaired tendon. If the tissue quality is poor, which is often the case in people with a long-standing history of tendinitis, the surgeon may recommend a tendon transfer to augment the repair and give the Achilles more strength.

The vast majority of individuals who have gone through an Achilles tendon surgery have the ability to return to all the tasks they did prior to the injury, including returning to the sport they were participating in when injured.

The success of your surgery can depend on the type of surgery chosen, the level of tendon damage, and how quickly your recovery program begins following surgery, as well as how well you follow the program.

There are a number of protocols for recovery following a surgical procedure for a rupture that will be provided to you by your NY Achilles tendon surgeon. Most surgeons will recommend a period of immobilization following surgery, with early motion within the first couple of weeks once the wound has healed. Movement can be started quickly following the surgical procedure, however weight bearing should be delayed. For people at higher risk for issues, weight bearing may be restricted for a longer period of time.

As a whole, most patients go back to weight bearing and begin physical therapy at 6 weeks, with gradual return to low impact activity by 3 months. Many people who are athletes do not go back to their sporting activity for approximately 6 months, but recovery is completely dependent on the injured person and how dedicated they are to recovery.

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