What is it?
Several operations are used for Achilles problems. A recent rupture can be repaired by stitching the tendon ends together, although many ruptures heal well without surgery in a special boot. An older (neglected) rupture may need reconstruction using a nearby tendon or a graft. For long-standing pain where the tendon meets the heel bone, the bony bump (Haglund's deformity) can be removed, the damaged tendon cleaned up and the tendon reattached. Releasing a tight calf muscle can also help some people with Achilles or heel pain.
Who might it help?
- An Achilles tendon rupture, especially in active people (both surgical and non-surgical treatment are discussed)
- A rupture that was missed or has not healed
- Achilles pain at the back of the heel that has not improved after several months of structured rehabilitation
Is it right for you?
Treatment is tailored to your individual needs, symptoms and goals. Surgery is only recommended when it is likely to help, and non-surgical options are always discussed first.
Mr Jeyaseelan will talk you through the benefits, risks and alternatives for your situation at your consultation.
What does it involve?
- Most Achilles operations are day cases under a general or regional anaesthetic.
- The exact operation depends on the problem and the condition of the tendon.
Before your operation
- You'll have a pre-assessment check, usually a week or two before surgery, including blood tests if needed
- Stop smoking, ideally at least six weeks before, as it slows bone and wound healing
- Arrange help at home for the first couple of weeks, and someone to take you home
- Prepare your home: clear walkways, and put everyday things within easy reach
- If you'll use crutches or a knee scooter, practise beforehand
On the day
- You'll be asked not to eat or drink for a few hours beforehand
- The anaesthetist will discuss the anaesthetic with you, often a general anaesthetic with a nerve block to keep the foot numb for several hours afterwards
- Mr Jeyaseelan will see you before the operation to answer any questions and mark the leg
- Before you go home, you'll be shown how to use crutches and given pain relief and written instructions
Recovery
You'll usually wear a boot with heel wedges for around eight to ten weeks, with weight bearing increased gradually. Physiotherapy then rebuilds calf strength. A return to running and sport commonly takes six to twelve months.
Foot raised, in a plaster or boot with the foot pointed down.
In a boot with heel wedges that are removed in stages. Weight bearing increases as advised.
Out of the boot. Physiotherapy to rebuild calf strength.
Gradual return to running and sport once strength has returned.
These times are typical only. You'll be given a personal recovery plan.
Getting back to normal
- Driving
- You can usually drive once you're out of a boot and can do an emergency stop safely. After right-foot surgery this is often six to eight weeks or more. Check with your insurer.
- Work
- Desk-based work is often possible after two to six weeks if you can keep the foot raised. Jobs that involve standing or walking take longer.
- Sport
- Low-impact exercise, such as cycling and swimming, usually comes first. Running and contact sport come later, once strength and movement have returned.
- Flying
- Long-haul flights are usually avoided for at least six weeks after foot and ankle surgery because of the risk of blood clots. Ask before booking travel.
Possible risks
As with any operation, there are risks. They include:
- Wound healing problems, as the skin over the Achilles is thin
- Infection
- Numbness on the outer side of the foot from nerve irritation
- The tendon rupturing again
- Calf weakness or a lengthened tendon
- Blood clots in the leg or lungs
Alternatives
Non-surgical treatment in a boot is effective for many Achilles ruptures. For tendinopathy, a structured loading programme, footwear changes and shockwave therapy are usually tried first.
Conditions this may treat
Common questions
Where can I have Achilles tendon surgery in London?
Mr Lucky Jeyaseelan, a consultant orthopaedic surgeon who specialises only in the foot and ankle, sees private and insured patients with problems that may need Achilles tendon surgery at Align Orthopaedics on Harley Street, The London Clinic on Devonshire Place, HCA London Bridge Hospital, HCA UK at The Shard, HCA UK City of London on Old Broad Street and The Holly Hospital in Buckhurst Hill, Essex. See all clinic locations or request an appointment. If surgery is right for you, he will discuss which hospital suits you best.
How long is recovery after Achilles tendon surgery?
You'll usually wear a boot with heel wedges for around eight to ten weeks, with weight bearing increased gradually. Physiotherapy then rebuilds calf strength. A return to running and sport commonly takes six to twelve months. Your own recovery plan will be tailored to you.
Is it covered by health insurance?
Mr Jeyaseelan is recognised by major insurers including Bupa, AXA Health, Aviva, Vitality and WPA. Cover depends on your policy, so please get an authorisation code from your insurer before your appointment.
Do I need a GP referral?
Self-funding patients can book directly, though a GP letter is helpful. Most insurers need a GP referral before they authorise your consultation, so check with yours first.
This information is general and is not a substitute for a medical consultation. Your diagnosis and treatment plan will be tailored to you.