Achilles Tendon Repair tendon repair

The Achilles tendon connects your calf muscles to your heel bone, and it carries enormous force every time you push off, climb stairs, or jump. When it tears completely — often during a sudden push-off in sports, felt as a sharp "pop" or a feeling of being kicked in the back of the ankle — the calf can no longer pull effectively on the heel. Achilles tendon repair is the surgery that reconnects the torn ends so the tendon can heal at the right length and tension.

Most repairs are done for an acute complete rupture. Surgery is also considered for chronic ruptures that went undiagnosed or untreated, where the gap between the tendon ends has widened and scarred, and occasionally for severe tendon damage (tendinopathy) that hasn't responded to a thorough course of conservative care. Partial tears and tendonitis usually do not need repair and are treated nonsurgically first.

Not every Achilles rupture requires an operation. Many can heal in a cast or boot held in a toe-down position, and modern functional bracing protocols have narrowed the gap between surgical and nonsurgical outcomes. At LAOSS we walk through both paths honestly — your age, activity goals, the size and location of the tear, how soon it's caught, and your overall health all factor into the right call.

Achilles tendon repair is usually an outpatient procedure done under regional or general anesthesia, often with a nerve block for comfort afterward. The goal is to bring the torn tendon ends back together and secure them at the correct length and tension so the tendon heals strong.

• Open repair — The surgeon makes an incision at the back of the ankle, locates the two frayed tendon ends, and weaves strong, non-absorbable sutures through each end (commonly a Krackow or similar locking stitch) before tying them together. This gives a direct view and a robust repair.
• Minimally invasive (percutaneous) repair — Through one or more small incisions, the surgeon uses a guide or jig to pass sutures across the rupture and pull the ends together. Smaller incisions can mean fewer wound-healing problems; care is taken to protect the nearby sural nerve.
• Chronic or large-gap ruptures — When the ends can't be brought together directly, the surgeon may lengthen the tendon (a V-Y advancement), transfer a nearby tendon such as the flexor hallucis longus to reinforce it, or augment the repair with graft tissue.

The ankle is then positioned slightly toe-down to take tension off the repair and placed in a splint, cast, or walking boot. The specific technique is chosen based on whether the tear is acute or chronic, the quality of the tendon tissue, your skin and circulation, and your activity goals.

At LAOSS, our foot & ankle specialists combine advanced surgical expertise with a patient-first approach. From minimally invasive arthroscopic techniques to reconstruction, fracture care, and arthritis management, our physicians bring decades of experience to every case. Trusted across Los Angeles, our team is dedicated to restoring mobility, relieving pain, and helping you return to the activities you love.

A torn Achilles is one of those injuries where getting seen quickly genuinely matters — repairs are often more straightforward when the tear is caught early, before the tendon ends retract and scar. At LAOSS, you can get a same-day or next-day evaluation for an acute injury at any of our eight Los Angeles–area offices, with X-ray and ultrasound on site and MRI available when soft-tissue detail is needed.

Our board-certified foot & ankle surgeons perform these repairs themselves and stay involved from diagnosis through the last phase of rehab. We'll confirm the tear with a focused exam (including the Thompson calf-squeeze test) and imaging, lay out the surgical and nonsurgical options in plain English, and coordinate physical therapy with your in-network provider so your recovery has structure from day one.

If you felt a sudden pop in the back of your ankle, have trouble pushing off or rising onto your toes, or have weakness that isn't improving, don't wait it out. Call or book online and we'll get you evaluated promptly.