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. 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.
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