An image of a wrapped, injured ankle on a soccer pitchA recreational soccer player suddenly changes direction to chase down a pass when she feels a pop and a sharp pain in the back of her ankle. She has trouble walking off the field. Later, a physical examination and MRI confirm the diagnosis: an Achilles tendon rupture.


The Achilles tendon is the largest tendon in the body, connecting the calf muscles to the heel bone. It plays an essential role in our ability to walk, run and jump. An Achilles tendon rupture (also known as an Achilles tendon tear) occurs when fibers of the tendon separate, either partially or completely. It is a common athletic injury, especially in sports that require sudden starting and stopping, such as basketball, soccer and tennis.


Our team includes surgeons who specialize in sports medicine and foot and ankle conditions. They have treated many Achilles tendon injuries using both surgical and nonsurgical methods. Treatment for an Achilles tendon rupture depends on several factors, including age, activity level and extent of injury. For older adults and people who are not very active, nonsurgical treatment – which typically includes wearing a cast or boot for several weeks, followed by physical therapy – could be the ideal option. For many others, surgical intervention may be recommended. Fortunately, a minimally invasive option is available.


What happens during minimally invasive Achilles tendon repair?


Your surgeon will begin by making a small incision on the back of your ankle near the tendon rupture. Then, using a special device, your surgeon will pass sutures through both parts of the tendon, above and below the tear. The sutures are then tightened and tied, pulling both ends of the tendon together and closing the tear.


What are the advantages and disadvantages of minimally invasive surgery for Achilles tendon repair, and how does it compare to open surgery?


Whether minimally invasive or open, orthopedic surgery to repair a ruptured Achilles tendon offers patients a few advantages over nonsurgical treatment. The main advantage is that patients can expect to regain normal or near-normal strength from a surgically repaired Achilles tendon. Nonsurgical treatment typically results in a weaker tendon, which puts the patient at higher risk for re-injury.


As with any type of surgery, there is a small risk of infection and complications from anesthesia. However, minimally invasive surgery requires a smaller incision than open surgery, which decreases infection risk, wound complications and scar adhesions (a condition that occurs when scar tissue forms and binds the tendon to surrounding tissue).


Am I a good candidate for minimally invasive Achilles tendon repair?


Because surgery offers a better chance of regaining normal strength in the injured leg, younger patients and active, middle-aged patients who wish to return to previous levels of activity are good candidates for surgery. Surgical repair is by far the most common option for athletes who have experienced an Achilles tendon rupture.