About Achilles Tendon Rupture
Injury to this dense band of tissue most commonly occurs in males, ages 40 - 60, often when playing basketball or tennis. The most common thing they say is, “Doc, I heard a gunshot go off and then realized my Achilles tendon ruptured.”

The physical examination is relatively straightforward as the tendon rupture is just above the heel and the muscle retracts the tendon towards the knee. The defect is usually palpable with a finger. Grasping the calf and squeezing it usually fails to plantar flex the foot, indicating a rupture between the muscle and the insertion of the tendon on the calcaneus in the foot.

Fortunately, Achilles tendon ruptures can be repaired with a percutaneous surgical technique that we have modified at The Stone Clinic over the past 20 years. By passing sutures through the skin and pulling the ruptured ends of the tendon together, the tendon has a chance to heal back to its normal strength. At The Stone Clinic, we specifically avoid making an open incision to repair Achilles tendons in order to preserve the blood clot and tendon sheath that surrounds the tendon itself. By not opening it, the growth factors released in the blood clot are there to help speed the healing of the tendon and the tendon heals with considerably less scarring and less risk of infection.

Percutaneous Achilles tendon repair is performed as an outpatient procedure with a local anesthetic. The patient is started on a rehabilitation program immediately and progresses over the next three months to retain their calf strength.

Patients at our Clinic have returned to full sports over the years with an extremely low re-rupture rate. Re-rupture is usually only due to knee trauma.

Achilles Tendon Rupture and Repair Slideshow
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Signs & Symptoms of an Achilles Tendon Rupture
The patient usually reports feeling a "shot" in the back of the calf and then having sharp pain. Swelling typically occurs from the bleeding associated with the tendon rupture.

Diagnosis of Achilles Tendon Ruptures
The diagnosis is made by history and physical exam. The rupture can be confirmed with a positive Thompson test: The examiner squeezes the calf while the patient lies on their stomach, normally causing the foot to point like a ballerina. When the Achilles tendon is completely torn, the foot does not point because the tendon connecting the large muscles of the calf to the heel bone is ruptured. Usually the defect in the ruptured tendon can be felt by the examiner as well. We then define the type and area of the tear with an MRI.

Treatment for Achilles Tendon Ruptures
The Achilles tendon can be surgically repaired with the following procedures:
   1. Percutaneous Repair - A minimally-invasive approach to repairing a ruptured Achilles tendon.
   2. Open Repair
   3. Open Reconstruction with Allograft (donor tissue)