Aftercare
It is important that the Achilles tendon is given enough time to regenerate, which is why careful follow-up treatment is urgently required. After an operation, good wound healing is essential for the further healing process. For this reason, care should be taken to irritate the surgical site as little as possible in the first days after the operation.
In addition, anticoagulant medication such as heparin is prescribed in the initial period, as well as painkilling medication. The common procedure after the operation follows the concept of early functional aftercare. This means that after a short time the foot can be put under good weight again.
This is achieved by putting on a special shoe, which is usually put on after three to five days after the operation. The shoe is usually worn for the next six to eight weeks, with physiotherapy usually starting after the third or fourth week. During this time, however, regular examinations should be carried out to ensure that the tendon heals well. Light sports activities can be started after 12 weeks. A special insole to relieve the tendon should be worn for at least half a year.
Rehabilitation
Regardless of the form of therapy for the Achilles tendon rupture, exercise therapy should follow. In the context of the conservative therapy, in which the patient was supplied with special shoes, the leg is already after a short time again fully loadable, so that the movement therapy can be already begun approximately three weeks after the tear. Statistical surveys show that it is not necessary to wear the shoes after about eight weeks.
Especially after the surgical treatment of the Achilles tendon rupture, mobilising physiotherapy should be carried out. It can generally be assumed that the patient will be able to exercise the Achilles tendon again after about three to four months. For active athletes, however, the following applies: training in the sense of competition training should only be resumed after about six months of rest. The extent to which one will be able to achieve peak performance again varies greatly from individual to individual.
Risks
The risk of an operation on the Achilles tendon can be considered very low nowadays. Modern anaesthetics and a well-rehearsed surgical team can keep the risks of the operation to a minimum. Nevertheless, as with any operation, certain risks cannot be excluded.
Since an incision is made through the skin during the surgical procedure, there is a risk of infection of the wound. The most common form of wound healing disorder is a highly pigmented, conspicuous scar. However, such consequences can easily be avoided by proper wound care, such as regular dressing changes and disinfectant ointments.
If the wound healing disorder is known, e.g. in the context of diabetes mellitus, there is the possibility of preventive antibiotic administration. In rare cases, nerves can also be damaged by the operation, especially the purely sensitive sural nerve. Since it runs directly next to the Achilles tendon, it can be overlooked and damaged.
If the nerve is accidentally injured, numbness or discomfort occurs in the area of the heel and the lateral edge of the foot. However, experienced surgeons can usually locate it well. Feared, though rare, is a repeated rupture of the Achilles tendon after the operation.
The physician then speaks of a “rerupture”. Statistically, this occurs after an operation in 1-4% of cases, depending on the study, and thus performs better than conservative therapy without surgery. In addition, there is a risk of considerable loss of strength and a reduction in mobility after an operation.
This must be prevented by careful aftercare and consistent treatment with physiotherapy. However, in the case of competitive athletes, it cannot be guaranteed that the performance after the operation will match the performance before. In most cases, the operation can be performed under local anaesthesia (local anaesthetic), so that possible risks of general anaesthesia are excluded.