Some problems have an obvious solution. Is a cold draft running through your house? Shut the door already! Don’t like what’s on the TV? Change the channel, or maybe turn it off and find a good book instead.
When it comes to finding the best way forward after an Achilles tendon rupture, however, there is a clear fork in the road—each with its own pros and cons. As a matter of fact, there’s still a lot of controversy in the podiatric world over which solution is best! Choose the path on the left, and you’re looking at surgical repair. To the right, you’re looking at more conservative methods of treatment. Which should you choose?
That depends on a lot of factors. How old are you? How severe is the tear in the tendon? How active is your lifestyle? What other kinds of considerations—work, sports, goals, etc.—are at play? There’s not necessarily a right or wrong answer, but depending on your circumstances we may recommend one option over the other.
First, let’s take a look at what each treatment looks like. If you go with surgery, your surgeon will make a small incision near the injured tendon and stitch the torn ends back together. If necessary, we may also use tendon transfers or grafts for reinforcement. By comparison, the non-surgical approach involves simply placing your leg in a cast or firm boot with the toe pointed downward, and letting your body’s own repair mechanisms perform the work. Either way, you’ll need to follow up with physical therapy and home care in order to return your ankle, tendons, and muscles to full working order.
You might be thinking, “Why get surgery if I don’t have to?” That’s a reasonable question, but the surgical option does have advantages. For starters, clinical evidence suggests that surgery tends to come with a lower risk of future re-injury. Patients who choose surgery also tend to recover and return to pre-injury activities more quickly. Finally, some studies suggest expected long-term strength and function outcomes are a little better on average for those who choose surgery, although that conclusion is in dispute.
But surgery has its drawbacks, too. Most obviously, by choosing conservative immobilization, you bypass all the standard risks that come with any surgical procedure, including infection, scarring, blood clots, or accidental nerve injury. It may be cheaper, as well, depending on your insurance coverage.
Because of the balance of pros and cons, surgery tends to be preferred by patients who are younger, more active, or have suffered a previous tendon rupture. Conservative care, meanwhile, tends to be the treatment of choice for seniors, less active adults, or those with medical conditions that would increase the complication risks inherent in any surgery. However, there are exceptions, and we always do everything we can to lay out your options clearly and help you make the choice the works best for you. To book your appointment, please call Family Foot & Ankle Center at (888) 689-3317.