Our Summary

This research paper discusses the case of a 46-year-old woman who had a severe Achilles tendon injury after falling, which happened after she had surgery on her heel and Achilles tendon. She had pain in the back of her ankle and her Achilles tendon was pulling away from its normal position. Her treatment options were to either keep her foot still and let it heal on its own or have surgery. She chose to have surgery, where doctors lengthened her calf muscle and stitched her Achilles tendon back to her heel bone. One year after the procedure, she was pain-free and could use her foot normally again. The surgery was successful in fixing and lengthening her Achilles tendon.

FAQs

  1. What is the treatment for an insertional Achilles tendon rupture?
  2. What is the Krackow suture technique and how is it used in Achilles tendon repair?
  3. What was the outcome of the surgical repair of the ruptured Achilles tendon in the case study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tendon repair is to follow a structured rehabilitation program to ensure proper healing and strengthen the tendon. This may include physical therapy exercises, stretching, and gradually increasing activity levels as directed by your healthcare provider. It is important to follow your doctor’s instructions carefully to optimize your recovery and prevent further injury.

Suitable For

Patients who are typically recommended tendon repair are those who have suffered a tendon rupture or tear, particularly in the Achilles tendon. This may occur as a result of trauma, overuse, or degenerative changes. Patients with significant tendon retraction or inability to bear weight on the affected limb may benefit from surgical repair to restore function and prevent further complications. Tendon repair may also be recommended for patients with chronic tendon issues that have not responded to conservative treatments such as physical therapy or immobilization. The decision to undergo tendon repair is typically made in consultation with a healthcare provider based on the individual patient’s symptoms, functional limitations, and overall health.

Timeline

Before tendon repair:

  • The patient suffers an insertional Achilles tendon rupture secondary to a fall.
  • Examination reveals posterior ankle pain with insertional Achilles tendon retraction.
  • Treatment options are discussed, including continued immobilization vs. surgical repair.

After tendon repair:

  • The patient undergoes Achilles tendon tenodesis to the calcaneus using a combined gastrocsoleus recession and Krackow suture technique.
  • At the 1-year follow-up, examination reveals pain-free return to normal function.
  • The repair provided sufficient lengthening and fixation of the Achilles tendon complex, leading to successful outcomes for the patient.

What to Ask Your Doctor

  1. What caused my tendon rupture and is there anything I can do to prevent it from happening again in the future?
  2. What are the risks and benefits of surgical repair versus non-surgical treatment options for my tendon injury?
  3. How long is the recovery process expected to be after tendon repair surgery?
  4. Will I need physical therapy after surgery and if so, how long will I need to participate in it?
  5. Are there any restrictions or limitations I should be aware of during the recovery process?
  6. What are the expected outcomes and success rates for tendon repair surgery in cases similar to mine?
  7. Are there any alternative treatments or procedures that could be considered for my tendon injury?
  8. What is the post-operative care plan and follow-up schedule after tendon repair surgery?
  9. What signs or symptoms should I watch for that may indicate a complication or issue with the healing process?
  10. Are there any lifestyle changes or modifications I should consider to support the healing and recovery of my tendon injury?

Reference

Authors: Casciato D, Mendicino R, Steginsky B. Journal: JBJS Case Connect. 2022 Jan 5;12(1). doi: 10.2106/JBJS.CC.21.00442. PMID: 34986130