The Achilles tendon is vital for walking, running, and jumping, and when it ruptures, surgical repair is often necessary to restore movement and strength. Although Achilles tendon repair surgery is generally successful, it does carry certain risks and possible complications that patients should understand before going ahead. Being aware of these challenges not only helps people make informed choices but also supports a smoother recovery. With the expert care of Professor Paul Lee and the dedicated team at MSK Doctors, patients receive thorough support throughout both surgery and rehabilitation.

Infection and Wound Healing Problems

One of the main concerns following Achilles tendon repair is the risk of infection. Post-surgery infections, though relatively rare, can cause delays in healing and may lead to further complications if not recognised promptly. Signs to watch out for include redness, swelling, warmth, unusual pain, or discharge near the wound. Sometimes, wounds take longer than expected to heal, which may indicate an underlying problem. Spotting these early warning signs is crucial for timely treatment.

Recent advances offer encouraging solutions. For example, a recent study described ultrasound-guided percutaneous repair as a “minimally invasive method in the treatment of Achilles tendon rupture.” This approach uses small incisions and ultrasound imaging to guide the surgeon, reducing tissue damage and lowering the chance of infection compared to traditional open surgery.

To help prevent infection, patients should follow wound care instructions carefully, maintain good hygiene, avoid putting strain on the injured area, and keep up with all follow-up appointments. Professor Paul Lee’s extensive experience with complex orthopaedic cases, combined with MSK Doctors’ attentive postoperative care, ensures any signs of trouble are addressed quickly and effectively.

Nerve Damage and Other Surgical Risks

While infection is a key risk, nerve injury is another important complication to be aware of. During surgery, nearby nerves—especially the sural nerve that runs near the Achilles tendon—can be at risk. Damage to this nerve might cause numbness, tingling, or altered sensation around the foot or ankle. If patients notice these symptoms, it’s important to inform their surgical team promptly.

Excitingly, modern imaging technology helps reduce this risk. One study found that “the sural nerve can be easily displayed by high-frequency real-time ultrasonography,” allowing surgeons to avoid it during minimally invasive repairs. Nonetheless, as research has noted, “Sural nerve injury is one of the commonest complications following this method of repair.” To combat this, surgeons have developed techniques involving “a less invasive approach to the tendon, accurate opposition of the tendon ends, and minimises the chance of sural nerve injury.” With Professor Paul Lee’s meticulous surgical technique and MSK Doctors’ close monitoring, nerve complications are carefully minimised and managed.

Prolonged Recovery and Failed Repair

Sometimes, healing does not proceed as expected. Patients might experience delayed recovery, re-rupture of the tendon, or in rare cases, failed repair. Symptoms such as sudden pain, loss of mobility, or persistent swelling should prompt immediate consultation with the surgical team.

Innovative materials and devices are now being developed to improve repair success, especially in more severe cases. For example, recent research has introduced hybrid textile medical devices designed to replace parts of the Achilles tendon. These structures “presented a non-linear force-strain curve comparable to a representative curve described for a native tendon,” which means they mimic the natural tendon’s behaviour well. The authors suggest that “the obtained values for the hybrid structures are promising for AT replacement,” offering hope for better long-term outcomes by combining strength with flexibility.

If complications arise, surgeons may consider revision surgery, detailed imaging, or tailored rehabilitation programmes. Professor Paul Lee’s deep expertise in orthopaedic rehabilitation, supported by the comprehensive care at MSK Doctors, ensures personalised treatment plans to support recovery and address any setbacks effectively.

Long-term Concerns and Minimising Risks

Beyond early recovery, patients should also be mindful of longer-term issues. These may include persistent pain, stiffness of the tendon, altered walking patterns (gait), and an increased risk of blood clots such as deep vein thrombosis (DVT). Successfully managing these concerns calls for ongoing vigilance and commitment to rehabilitation.

Patients are encouraged to closely follow prescribed physiotherapy routines, stick to medical advice, and report any unusual symptoms without delay. Regular follow-ups with specialists like Professor Paul Lee and the MSK Doctors team play a crucial role in early detection and prompt management of any emerging problems. Staying attentive to these Achilles tendon repair complications and Achilles tendon surgery risks helps support lasting mobility and a return to normal life.

Conclusion: Responsible Advice for Patients

While Achilles tendon repair surgery does come with potential risks, careful postoperative care, early recognition of issues, and support from experienced professionals can greatly reduce their impact. Patients are advised to seek personalised advice from qualified experts such as Professor Paul Lee and the MSK Doctors team to ensure the best possible recovery and long-term outcomes.

For individual medical advice, please consult a qualified healthcare professional.

References

Mazek, J., Gnatowski, M., Salas, A. P., Domżalski, M., & Mazek, M. (2023). Ultrasound-guided Percutaneous Achilles Tendon Repair. Techniques in Foot & Ankle Surgery, 23(1), 21-26. https://doi.org/10.1097/btf.0000000000000399

Carmont, M. R., & Maffulli, N. (2007). Modified percutaneous repair of ruptured Achilles tendon. Knee Surgery Sports Traumatology Arthroscopy, 16(2), 199-203. https://doi.org/10.1007/s00167-007-0411-z

Peixoto, T., Carneiro, S., Pereira, F. A. M., Santos, C. L., Fangueiro, R., Duarte, I., Paiva, M. C., Lopes, M. A., & Guedes, R. M. (2022). Hybrid structures for Achilles' tendon repair. Polymers for Advanced Technologies, 33(7), 2362-2373. https://doi.org/10.1002/pat.5693