Achillis Re Rupture ! Op or Coservative ?

Andrew, I had surgery end of October by January I was walking with a limp, by February after physio (6 months since op) i was walking without a problem. I have heard from these forums people who have gone down the non-surgery route and still struggling 6 months down the line. I would op for surgery. 

Thats really bad news; what happened? I had a long chat with consultant re operative or conservative treatment when mine went last september. His take was that an operation had infection risks and if a re-rupture occured surgury was still an option. My tendon is fine but still suffering from a weak calf after immobilisation.From a quick google:

"In a meta-analysis conducted by Khan et al., including 12 randomized control trials and 800 patients, open surgery was associated with lower risk of re-rupture than non-operative treatment but higher risk of other complications, especially wound problems [15].Surgical treatment seems to be the method of choice for young people, athletes, and delayed ruptures. There is no single, uniformly accepted surgical technique, and the options include open repair, with or without augmentation, and percutaneous techniques"

Thanks for your replys

When it first went they offered both treatment methods and i went with their recommendation none Op .I hadn't been told first time round that it was complete rupture i found that out today !

I'm a very sporting active 43yo with a practical job 

This new consultant was looking at my old X-rays till I told him it's a RR. He was not even going to do Ultrasound till I said I was not happy and he didn't recommend anything other that Coservative treatment . 

He back tracked then (when I asked what's the point of US test if they weren't going to look at different treatments ) saying if its gone completely they would put me under the knife

I question him about lower RR risks after op but he was pushing the risk of infection thing until I asked if he was going to pay my wages if it went a 3rd time .

I would rather not have an op but really can't face it going again I was in bits the second time 

 

I think the first question I would ask is how did it rupture again.  I am 10 weeks down the line with conservative treatment and am just about to ditch the boot and start more progressive physio.

I have been told and have read that there is more of a chance of re-rupture with conservative treatment but I think a lot depends on your lifestyle as well.  I have been very sporty all my life and indeed was playing a competitive table tennis match when I ruptured mine and I have to accept that I probably (at the age of nearly 66) won't be able to play competitive games again which is a shame.  Just have to get out walking/hiking I suppose.

Anyway I would always go for the non-operative route because for me there is too much risk associated with post-operative infections (e.g. MRSA etc.). 

Best of luck, Chris L

Have also just read the other replies and there is a lot of common sense there.  Just confirms that there is no definitive answer and my best advice would be to go with your gut feeling.  The road is long and we have to learn to be patient.  Like you my job is completely hands on including a LOT of lifting and so I am going to have to be at least 90% fit at least before I can think about resuming the job.

Again, good luck

Chris L

Hi Chris

I was just walking on the flat when it went nothing more than that 

The physio said I was doing really well done a few light short stationary cycles under her say so all been fine , back driving , with the consultants signing me off 

i know there is no mirical cure but after going through this once and it failed I'm scared to do the same again with the same end result 

 

So I've just come back from ultrasound it's not good at all 

I'm feeling so fed up can't put how i really feel !!! Its in such a mess they can't do an op as there is nothing good to stitch on too

ive now got no income again 

 

Feel sorry for you andrew, i am on conservative treament as well ,its my 2 week on cast, my doctor said he may need to put me on cast for 8 weeks, i dont have swelling and pain. But after i read your post, i lso fear that I will suffer the same faith. Hope everything goes well with you.. Feel better soon!

So they finally decided to do op just over a week ago 

there was a 4cm gap to join 

sat at home with leg up go back in week Tuesday to have stitches out 

and possibly back to air cast boot  

Hi. How's it going buddy?  I will try to call you later to see how it went today.  Mine is progressing well ( I think)  hobbling around now without crutches for bits of the day.  You must be looking forward to getting in that sweaty boot again.....

Hi all

Thought I would update this to help and encourage all those going through

achillis problems

I had Op after rerupture I had 5 weeks in plaster and 8 in the boot reducing wedges every so often

Im now back walking with a limp but less of a limp than first time round 

Its also great to be back driving

Im due into phsyo any time now but have started some of the basic exercises that a was given after the first rupture 

My encouragement to you all is stick with it even when your feeling pants

It takes time but it does get better :-)

sorry to hear about that. first of all consider the facts from surgery. infection occurs in less than 10% of people operated on. Now do these people: smoke, have poor hygiene, have a skin infection already, etc etc. surgery is the secure way forward in my opinion. i am 6 weeks in and walking in an air boot. wound has virtually healed. no infection, no blood clot (touch wood) on course to be walking without the boot in 6 weeks