Our Summary

This research paper discusses a severe complication that can occur after repairing a ruptured Achilles tendon - a deep infection. This infection requires not only antibiotics, but often the removal of some or all of the Achilles tendon. The authors share a successful case where they reconstructed a chronically infected Achilles tendon in a 43-year-old man. They adopted a multi-step approach, using two other tendons from the foot (the flexor hallucis longus and the peroneus brevis) for the reconstruction. The paper also briefly reviews other research on using local tendons for Achilles tendon reconstruction.

FAQs

  1. What is a major complication that can occur after repairing a ruptured Achilles tendon?
  2. How did the researchers successfully reconstruct a chronically infected Achilles tendon?
  3. What other research has been done on using local tendons for Achilles tendon reconstruction?

Doctor’s Tip

One important tip that a doctor might tell a patient about tendon repair is to follow post-operative care instructions closely to reduce the risk of infection. This may include keeping the surgical site clean and dry, taking prescribed antibiotics as directed, and attending all follow-up appointments with the doctor. Additionally, it is important to avoid putting too much strain on the repaired tendon too soon, as this can increase the risk of re-injury. Physical therapy and rehabilitation exercises may also be recommended to help strengthen the repaired tendon and improve range of motion.

Suitable For

Patients who are typically recommended tendon repair are those who have suffered a tendon rupture or injury that affects their daily activities or mobility. This can include athletes, individuals with chronic tendon pain or weakness, and those who have experienced trauma to the tendon. In some cases, patients with chronic infections in the tendon may also be recommended for tendon repair to prevent further complications.

Timeline

Before tendon repair:

  1. Patient experiences a traumatic injury or gradual degeneration of the tendon.
  2. Patient may undergo imaging tests such as MRI to diagnose the extent of the tendon injury.
  3. Patient may undergo conservative treatments such as physical therapy or immobilization to manage symptoms.
  4. If conservative treatments are ineffective, patient may undergo surgery for tendon repair.

After tendon repair:

  1. Patient undergoes surgery to repair the ruptured tendon.
  2. Patient may need to wear a cast or boot to protect the repaired tendon during the initial healing phase.
  3. Patient undergoes physical therapy to regain strength and range of motion in the repaired tendon.
  4. Patient gradually returns to normal activities and sports, with the guidance of their healthcare provider.
  5. In some cases, patients may experience complications such as infection, which may require further treatment such as antibiotics or additional surgery.
  6. With successful rehabilitation and healing, patient may achieve full function and mobility in the repaired tendon.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with tendon repair surgery?
  2. How long is the recovery period after tendon repair surgery?
  3. Will physical therapy be necessary after the surgery, and if so, for how long?
  4. What are the expected outcomes of tendon repair surgery in terms of pain relief and functional improvement?
  5. Are there any alternative treatment options to tendon repair surgery that I should consider?
  6. How often do complications such as deep infections occur after tendon repair surgery?
  7. What steps can be taken to reduce the risk of developing a deep infection after tendon repair surgery?
  8. How will the reconstruction of the Achilles tendon using other tendons from the foot affect my overall mobility and function?
  9. Are there any long-term effects or limitations I should be aware of after undergoing Achilles tendon reconstruction?
  10. What is the success rate of using local tendons for Achilles tendon reconstruction compared to other methods?

Reference

Authors: Simonson DC, Elliott AD, Roukis TS. Journal: Clin Podiatr Med Surg. 2016 Jan;33(1):153-62. doi: 10.1016/j.cpm.2015.06.006. Epub 2015 Jul 8. PMID: 26590732