Revision Surgery for the Achilles Tendon

Abstract

Treatment of Achilles tendon ruptures may be surgical or nonsurgical depending on health, history, age, acuity, and severity of the injury. With chronic or revisional injuries, the best method often requires an open repair with reconstructive soft tissue procedures. Revision surgery can be challenging because of the complexity involving tendinous deficits with nonviable and friable tissue. Surgical treatment is based on tendon approximation, size of the defect, tendon integrity, and functional demands. The goal is to restore anatomic and physiologic tension, provide adequate strength for proper ambulation, optimize functional return to activity, decrease pain, and decrease complications.

Keywords: Allografts; Augmentation; Autografts; Gastrocnemius lengthening; Reconstruction; Revisional Achilles tendon; Tendon transfer; Turndown flap.