Achilles tendonitis treatments include rest, allowing the tendon to heal and also physiotherapy, resulting in recovering the strength and the flexibility and prevent further fracture. The treatment of the Achilles tendon rupture includes tendonitis surgery and splints, plaster or any other boot device which keep the joint immobilized (it can not move). An early treatment usually results in an effective cure, and it is not necessary to perform tendonitis surgery.
But in this case it is not indicated the treatment by tendonitis surgery. You can require a tendonitis surgery, if the forces of friction between the tendon and the tissue which covers the tendon (tendon sheath), result in the swelling and the fibrosis of the tendon. In this case by tendonitis surgery it is removed the fibrous tissue and it is repaired the existing small cracks, preventing thus the occurrence of further fractures.
Achilles tendon rupture
Tendonitis surgery is the usual treatment of tendon rupture, allowing the unification of the two ends of the tendon. This procedure significantly reduces the occurrence of subsequent fractures compared with the use of joint immobilizers. The results are much better when the tendonitis surgery takes place shortly after the lesion had produced. Postoperative recovery may take several months and requires association with physiotherapy. This cure must be applied cautiously because it may promote tendon rupture. If there is no improvement after 6-12 months it may be used the surgery or the classical (open) treatment to repair the damaged structures and to reduce the pressure on the tendons and bursas.
Tendonitis surgery of the Achilles tendon rupture may be through large incision or per cutaneous incision:
If large incision, the surgeon practice a single incision in the back of the leg and connects the two free ends of the ruptured tendon by suture
In per cutaneous treatment, the surgeon makes several small incisions which enable to unite the two free ends of the tendon rupture by suture.
Sometimes it is difficult to assess whether tendonitis surgery is effective because of the different age and the different physical activity level of the patients. The success of tendonitis surgery depends on the practical experience of the surgeon, the type of procedure, how the tendon is damaged, how quickly the surgery has been made after the injury and how quickly the rehabilitation program begins after surgery.
Both types of tendonitis surgery are effective: the difference lies in the different degree of occurrence of potential complications and the possibility of developing a new fracture
Although per cutaneous incision has a higher risk of occurrence of subsequent rupture, recent studies have shown that the risk depends on how early begins the mobilization after surgery (1% -2% for a large incision, and only between 3.5% -6.5% for per cutaneous incisions)
Open tendonitis surgery with large incisions has a higher rate of occurrence of postoperative complications than per cutaneous incisions, though the risk of nerve damage occurs more often when there are performed per cutaneous incisions. There are modern operator’s techniques which make less the possibility of nerve damage than the conventional techniques.
The preference for tendonitis surgery or for the classic treatment, in which are used immobilizers devices depends on:
Other tendon injuries in history and complications: the use of restraining devices increases the risk of new fractures, but decreases the risk of postoperative infectious complications
Activity level: in very active people usually is opt for tendonitis surgery
Age: in the case of older persons which have not an intense physical activity which can lead to a new rupture of the tendon, it is preferred immobilization with cast or splint boot
Health status: if the patient presents related diseases such as diabetes, heart disease or lung is preferable to use an immobilizer device
Age of the lesion: tendonitis surgery is addressed to tendon rupture which has less than two weeks.
Communicating with your doctor that will perform the tendonitis surgery is essential for finding some data such as the experience of the doctor, its success rate of other interventions, and the most appropriate technique.