More info about Achilles Tendonitis from AAOS

 

 

 

 

 

What to Expect:  Insertional Achilles Tendonitis/Bone Spur Removal

What is done?

  • A 4-6” incision is made on the back of your heel.
  • The bone spur on the back of your heel bone is removed and the Achilles tendon is reattached to the bone with special suture anchors.
  • Watch a cool video of the procedure at http://www.orthoillustrated.com/ankle/

 Where?

  • Takes about 1.5 hours. You will be completely asleep (general anesthesia.)
  • The anesthesiologist or surgery center nurse will call you the night before surgery to review details.
  • You will need someone to drive you home. Expect to be at the surgery center for at least 4 hours.

How long will healing take?  Expect about 75% healing within 6 weeks; full recovery takes up to 1 year.

You will go through 4 phases:

  • First 2 weeks: Control swelling/pain, protect the repair, NO weight-bearing. Crutches/walker/Roll-About.
  • Weeks 3-6: Protect the repair, gentle range-of-motion, weight-bearing in the Boot.  Crutches/cane.
  • Weeks 6-12: ASO ankle brace, start Physical Therapy to learn to walk smoothly, regain strength and endurance for sports and heavy work.
  • 3+ months: start cutting, pivoting, running, jumping
  • It’s OK to drive after a week or so IF you have LEFT ankle surgery and are confident about controlling your car. If you have RIGHT ankle surgery, it will take up to 2 months.  Use common sense, and DON’T drive if you can’t safely manage the pedals.

 

Time out of work depends on your job.  Talk to your employer about returning to work with restrictions for the first few weeks after surgery.   Everyone is different, but generally:

  • Within 1 week: return to an office job with minimal walking, leg elevated, take breaks, use crutches/Roll-About.
  • 2-4 weeks: seated work with limited walking and stairs. No climbing, squatting or carrying >10 pounds
  • 6-12 weeks: if walking without a cane or limp, you can spend up to a few hours on your feet; start climbing, squatting or carrying.
  • 3+ months: no particular restrictions; use common sense.

 Rest, Ice and Elevation are the most important ways to relieve pain at first.

 What are the risks associated with this operation:

  • Infection or wound-healing problems.
  • Medical problems related to anesthesia, like heart or breathing complications.
  • Excessive bleeding or bruising, especially if you’re on blood thinners or bruise easily.
  • Blood clot, which can be dangerous if it travels from your leg vein to your lungs. If you have a history of blood clots, we’ll work with your primary-care doctor on prescribing blood-thinners postop to prevent another one.
  • Continued pain or stiffness in the ankle despite everything going as expected.
  • You could disrupt the repair if you do too much too soon. Follow the rehabilitation/healing protocol to ensure a good outcome.

Prepare for your surgery and you’ll have a speedy recovery:

  • See your primary-care physician for preoperative medical clearance (EKG if needed, etc…) and fill out the paperwork for the Surgery Center.
  • If you have chronic health issues, you may need to see your cardiologist or other specialist before surgery.
  • If you take Coumadin, Plavix or other blood-thinner, we’ll contact your doctor who prescribes it. Usually, patients stop taking their blood thinner 5 days before surgery, and re-start the day after.
  • Practice using your crutches, walker or Roll-About. Learn how to go up or down the stairs.
  • Stop taking any anti-inflammatory medicines (Motrin, Aleve, Ibuprofen, Aspirin…) and supplements like glucosamine 7 days before surgery to prevent excess bleeding (you’ll restart them after the operation.
  • Please write down any notes or questions, and bring them to your pre-operative visit for us to talk about.

 Stuff to make your recovery easier:  Borrow from your town’s lending closet, or get at Fonte Surgical.

  • Crutches or Walker and a cane—everyone needs these.
  • Roll-About—kneeling walker that makes it easier to move around and use your hands.
  • Vinyl cast cover—to keep your postop dressing dry for the first 2 weeks.
  • Large ice/heat packs—buy 2 and rotate through the freezer or microwave.