Advances in Achilles Tendon Tear Repair

Advancement in Achilles Tendon Tear and Achilles Rupture Care

The Achilles tendon is the strongest tendon in the body but it is also the one that is most commonly injured.  In this article we discuss the anatomy of the Achilles tendon as well as give an overview on Achilles tendon ruptures.

Achilles Tendon Anatomy

The Achilles tendon is approximately 15 cm in length and is made up of a combination of fibers that are derived from two calf muscles which twist 90o and insert at the back of the calcaneus or heel bone.  The Achilles tendon gets its blood supply from 3 sources.  There is an area on the Achilles tendon approximately 2 to 6 cm above its insertion to the calcaneus that has poor circulation and is called the watershed region.  Due to the diminished blood supply, this is a common area for Achilles tendon lesions and ruptures.

Acute Achilles tendon ruptures

Achilles tendon ruptures occur most often in middle-aged men during athletic activities.  Patients with Achilles tendon ruptures often say that they felt a sudden pop or snap in their calf with subsequent weakness or difficulty with ambulation.  Some say they felt someone kicked them or hit them from behind but there is noone in the vicinity.  Patients may be able to walk with minor swelling and pain after a tear but have weakness.

Achilles Tendon Tear Exam

On examination, a palpable defect in the tendon can be felt and there is often an increase in upward movement of the ankle due to the lack of tension from the Achilles tendon.  A common test that is used to evaluate the integrity of the Achilles tendon is the Thompson calf-squeeze test.  Squeezing the calf muscles on the affected side will yield little to no movement in the ankle when compared to the unaffected side.

Imaging of Achilles Tendon Tears or Ruptures

MRI and ultrasound are often used to confirm the presence of an Achilles rupture and to evaluate the extent of the rupture.  The diagnosis of Achilles tendon ruptures, however, is based on clinical examination.  Imaging is often used for surgical planning or in cases in which there are equivocal examination findings.

Achilles Tendon Tear Surgical Advancements

Operative and nonoperative methods offered by foot and ankle doctors have shown favorable outcomes.  Generally with surgical repair, there have been reports that there is a decreased rate of re-rupturing the tendon, improved strength, improved ankle motion, better return to activities, and fewer complaints.

Operative treatment involves reapproximating the two ends of the ruptured tendon together using special suture techniques.  A repair can be augmented with a tendon transfer, or synthetic graft.  Rarely, the Achilles tendon may rupture at its insertion into the calcaneus.  In these cases, a tendon anchor may be used to reattach the Achilles to the bone.  The patient is then put in a non-weightbearing cast for 4 to 6 weeks followed by gradual weight bearing and physical therapy.

University Foot and Ankle Institute Achilles Tendon Tear Advancements

University Foot and Ankle Institute has performed extensive surgical research into the ideal treatment and rehabilitation of Achilles tendon tears and ruptures.  By using a very strong stitching material, often augmenting the tear with a tendon wrap, and getting a very strong repair of the tendon, rehabilitation and cast removed is done rapidly.  By not casting the patient for a long time, the Achilles does not lose as much strength and return to activity is quicker.  University Foot and Ankle Institute is proud to offer the latest advancements in the repair of Achilles tendon tears and Achilles ruptures.

Dr. Bob Baravarian

Dr. Bob Baravarian

Dr. Bob Baravarian is a Board Certified Podiatric Foot and Ankle Specialist. He is currently a member of UCLA Medical Group, Chief of Podiatric Surgery at Santa Monica/UCLA medical center and Orthopedic Hospital and an assistant clinical professor at the UCLA School of Medicine. He also serves as co-director of University Foot and Ankle Institute. He is Editor Emeritus of the international medical journal, Foot and Ankle Specialist.

Dr. Baravarian been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy and trauma/reconstructive surgery of the foot and ankle. He servers as a consultant to the ATP (Association of Tennis Professionals) tour, multiple running organizations and several shoe manufacturers. He is also fluent in five languages (English, French, Spanish, Farsi and Hebrew),

Podiatrist Dr. Bob Baravarian is available for consultation at the Santa Monica, Sherman Oaks and UCLA Westwood offices.
Dr. Bob Baravarian

2 comments

  1. I think this info is the best I’ve ever seen in a medical practice. Thank you a lot for sharing this interesting topic, at least for me!

Leave a Reply

Your email address will not be published.

three × four =

  • Angies List
    He is very nice. He is really good with teens who don’t want to wear their orthotics. He is smart and helpful. He really was good at working with my daughter.
    Anonymous
  • Yelp
    Quick, painless, fantastic service.
    Mike G.
  • CustomerSure
    I'm very happy to be Dr. Campbell's patient! He is not only very well trained, but has a wonderful "bedside manner." He is easy to talk to and always puts me at ease during my visits to his office.
    Elissa H.
  • Yelp
    My first appointment, Dr. Barvarian personally came out to the waiting room, introduced himself, and walked me back to examine my foot; but only after taking a detailed history of what I do for a living, when my injur...
    Haley S.
  • CustomerSure
    We love Dr. Franson & staff!
    Michael M.
  • CustomerSure
    I love Dr. Gary Briskin, Gray O' Brien & the physical therapy staff in Santa Monica. Super nice people, and very helpful getting me back on my feet!
    Kira L.
  • Yelp
    I can't express how grateful I am for The University Foot & Ankle Institute! I rolled my ankle a while back, and these guys had me fast on the road to recovery. They have experienced surgeons and therapists and 8 loca...
    Steven K.
  • CustomerSure
    I always return to Dr. Briskin and UFAI because I know I will receive excellent treatment from Dr. B and the staff.
    Marilyn W.
  • Yelp
    Suzanne at UFAI saved my Ironman! I started to develop ankle stiffness about two weeks before my first Ironman. I was referred to Suzanne at UFAI in Valencia. With Suzanne's help and some emergency PT, I was able to ...
    Robert U.
  • CustomerSure
    Doctor did a fabulous job. My foot looks amazing! But most importantly, I have a very difficult time with anesthetic and I'm allergic to many medications, the doctor listened and took every step to make sure I had th...
    Dawn K.
Same day appointments now available!
or call 24/7:
  • University Foot & Ankle, a Preferred Provider to:
  • UCLA Health System - UCLA Medical Group
  • MPTF - Member Industry Health Network
  • Cirque du Soleil
  • ATP - Association of Tennis Professionals
  • And consulting physicians for:
  • C&S - Cedars-Sinai
  • Saint John's Health Center