Local Orthopedic Surgeon Brings Good News About Bad Ankles

How do I know if I ruptured my Achilles tendon?

Achilles injuries commonly occur during athletic activity. People may feel a pop or feel like they got kicked in the back of the heel and notice pain or difficulty walking. It is important to know that calf tears are often confused with a ruptured Achilles. These tears are higher up in the leg, in the calf muscle itself. Calf tears are different from Achilles ruptures and reliably heal on their own with a period of rest, ice, and compression wrapping. If you suspect an Achilles tendon injury, it’s best to be seen by an orthopedic surgeon to confirm the diagnosis and discuss the next steps in treatment.

Is surgery always the answer for a ruptured Achilles tendon?

It depends on the patient and their goals. I tell my patients that the recovery time is not different between early active rehabilitation (non-operative) and surgical repair. One year out from the rupture, the functional difference for most people may be the same whether you have surgery or not. There are other aspects to consider, such as rates of re-rupture and plantar flexion strength (which may slightly favor operative intervention). You should find a provider who will have an open discussion about each approach. To learn more, visit us at DallasOrtho.com.

What are the different types of Achilles tendonitis and treatment options?

We classify Achilles tendonitis as insertional or non-insertional. Insertional occurs where the Achilles inserts on the heel bone and often includes a bone spur. We see good results with PT, anti-inflammatories, and simple shoe wear modifications. If this fails to alleviate pain, surgery may be an option. The other type is non-insertional, where people experience swelling and pain an inch or two above the heel. For this, we instruct patients on an eccentric stretching and strengthening program with formal PT.

What is ankle arthritis?

Whereas arthritis in the hip and knee is generally related to wear and tear, most ankle arthritis is post-traumatic (after an injury). Generally, 80-90% of patients have had previous ankle fractures or sprains that wear out their normal ankle cartilage and the bones rub, which is painful. For these patients, we typically start with PT, bracing, steroid injections, etc. At a certain point, conservative management stops working, and patients may consider surgery.

What are the surgical treatments for ankle arthritis?

Surgical options are an ankle fusion or an ankle replacement. Historically, ankle fusion has been the tried-and-true treatment and involves taking the remaining cartilage away and healing the bones together to get rid of the painful joint motion. In the last decade or so, ankle replacement surgery has become much more successful and reliable. In an ankle replacement, we remove the worn-out joint and replace it with metal and plastic to preserve joint motion, much the same way we would do for a knee or hip replacement. This is becoming a popular alternative, as the technology continues to improve. If you have painful ankle arthritis, we will make a treatment plan together that gets you back to doing what you love with less pain and better function.