Surgery or Not? Deciding on Achilles Rupture Treatment

Vanilla or chocolate? Dogs or cats? Betty or Veronica? Surgery or not? While that last one may not be a “classic debate” in quite the same sense as the first three, it’ll be a very important concern for you and your doctor if you’re trying to decide how to treat an Achilles tendon rupture.

Thought process

Both options have shown success at treating this unfortunate, traumatic sports injury, although there are advantages and disadvantages for either approach. Making the right decision for your unique situation will depend not only your surgeon’s recommendations, but also how you weigh the relative risks and benefits.

We’ll start with the surgical approach. The exact surgical procedure chosen will depend on the severity of the injury, but it usually involves making an incision on the back of the leg at the site of the rupture. In a simpler case we’ll simply stitch the torn parts of the tendon back together; in other cases we may need to reinforce the injury with other tendons.

By contrast, the non-surgical approach involves merely immobilizing the foot and ankle via a cast or boot with a raised heel. This keeps your foot and tendon in a fixed, low-stress position, allowing the body to repair the torn Achilles through natural processes.

So what are the pros and cons? Surgery is often recommended, especially among younger or more active patients or when the injury is more severe, because the results tend to be better on average and healing occurs faster. In most cases a surgically repaired tendon and the supporting muscles end up a little stronger and less likely to rupture again.

However, in other cases, non-surgical care might be preferred. For one, although surgery has a high success rate, there are always risks, including infection or nerve damage. Choosing the conservative option bypasses those risks, which is an especially good deal for patients with medical conditions (such as diabetes) that may make surgery riskier. Furthermore, although the results tend to be a little less ideal than the surgical option, with a higher rate of re-rupture, it may be more than sufficient for patients who are a little older and less active.

Obviously, it’s not always an easy call, with important benefits and drawbacks to each choice. Thankfully, you don’t have to make that choice alone—Dr. Keith McSpadden of North Austin Foot & Ankle can help walk you through the pros and cons and help you arrive at the best option for you, your family, and your future. To schedule an appointment, please call us today at 512-593-2949.

Posted on March 8, 2016 .