Noelia Drumwright

Overview

The Achilles tendon is the largest tendon in your body and is responsible for pushoff up to 10 times body weight. Surgery is a common treatment for chronic Aquila?s tendinitis or complete rupture of the Achilles tendon. The Achilles tendon had connects the calf muscle to the heat. When the tendon tears or ruptures the variety of surgical techniques are available to repair the damage and restore the tendons function. Recent research that is done at Emory University Department of orthopedics have perfected the repair of the Achilles tendon. The procedure is generally involves making an incision in the back of your leg and stitching the torn tendon together using a technique developed and tested by Dr. Labib. Depending on the condition of the torn tissue the repair may be reinforced with other tendons. Surgical complications can include infection and warned healing problems. The repair performed at Emory allows the patient quick return to weight-bearing and function. Healing and return to full function may take up to four months.

Causes
The causes of an Achilles tendon rupture are very similar to Achilles tendinitis. Causes include. Running uphill. Running on a hard surface. Quickly changing speeds from walking to running. Playing sports that cause you to quickly start and stop.

Symptoms
Patients often describe a feeling of being kicked or hit with a baseball bat in the back of the heel during athletic activity. They are unable to continue the activity and have an extreme loss of strength with the inability to effectively walk. On physical examination there is often a defect that can be felt in the tendon just above the heel. A diagnosis of an Achilles tendon rupture is commonly made on physical exam. An MRI may be ordered to confirm the suspicion of a tear or to determine the extent of the tear.

Diagnosis
Diagnosis is made by clinical history; typically people say it feels like being kicked or shot behind the ankle. Upon examination a gap may be felt just above the heel unless swelling has filled the gap and the Simmonds' test (aka Thompson test) will be positive; squeezing the calf muscles of the affected side while the patient lies prone, face down, with his feet hanging loose results in no movement (no passive plantarflexion) of the foot, while movement is expected with an intact Achilles tendon and should be observable upon manipulation of the uninvolved calf. Walking will usually be severely impaired, as the patient will be unable to step off the ground using the injured leg. The patient will also be unable to stand up on the toes of that leg, and pointing the foot downward (plantarflexion) will be impaired. Pain may be severe, and swelling is common. Sometimes an ultrasound scan may be required to clarify or confirm the diagnosis. MRI can also be used to confirm the diagnosis.

Non Surgical Treatment
The other option is to allow your tendon to heal without surgery. In this case, you also need to wear a cast, splint, walking boot, or brace for 6-8 weeks. You also may have different exercises to do. If you are less active or have a chronic illness that prevents surgery, this option may be better for you.


Surgical Treatment
Unlike other diseases of the Achilles tendon such as tendonitis or bursitis, Achilles tendon rupture is usually treated with surgical repair. The surgery consists of making a small incision in the back part of the leg, and using sutures to re-attach the two ends of the ruptured tendon. Depending on the condition of the ends of the ruptured tendon and the amount of separation, the surgeon may use other tendons to reinforce the repair. After the surgery, the leg will be immobilized for 6-8 weeks in a walking boot, cast, brace, or splint. Following this time period, patients work with a physical therapist to gradually regain their range of motion and strength. Return to full activity can take quite a long time, usually between 6 months and 1 year.