The Achilles tendon is the strongest and perhaps one of the most important tendons in the body. Injuries to the Achilles tendon occur in two main ways: either a rupture or through chronic degenerative changes of the tissue. Ruptures can be partial or complete, although the most common are complete. A rupture of the Achilles tendon is a debilitating injury, as the ability to push off the ankle is lost.
The benefit of surgical repair to a full rupture is that a re-rupture of the Achilles tendon is unlikely, and the total length of recovery time is less than when non-surgical treatment is used. Of course, conservative treatment does not carry the risks commonly associated with surgery, infection being the most important in this case.
Chronic Achilles tendon disorders include tendonitis and tendonosis. The first condition is usually caused by overuse of the tendon resulting in inflammation, while tendonosis does not present with inflammation, and is caused by a failed healing of or repetitive trauma to the tendon. There are many conservative approaches to healing injured Achilles tendons, from stretching, icing and rest to complete immobilization. Only after these treatments fail is surgery considered, with the specific surgical treatment determined by the location of the abnormality, degree of tendon involvement and location of involvement.
While some tendon injuries are not amenable to minimally-invasive repair techniques, many can be repaired with the use of a special device requires only a small, centimeter long incision (approximately one-third of an inch). If the patient presents with an insertional Achilles tendons disorder, surgical repair is the only method as the spike of heel bone that is causing the irritation on the tendon must be shaved.
Because of the importance of the Achilles tendon for everything from simple walking to high-level activity, the function of this tendon must be respected and thorough consideration of all options should be considered with both conservative and surgical treatment individualized as appropriate for each individual.
For more information on these injuries and their treatments please see: