Post-Surgery Indentation After Achilles Tendon Repair

Depression after Achilles tendon surgery?

Hello, Director Wang! I underwent traditional Achilles tendon repair surgery at the end of last month (I had a complete rupture).
Yesterday, I had my cast and stitches removed, but it seems that the injured area is still indented, just like when I was first injured.
Is this normal? Will it eventually return to a slightly protruding state like it was before the injury? How can I tell if there has been any external force that caused the Achilles tendon to rupture again after the surgery? Actually, aside from some pain at the surgical site, I didn't feel any pain even at the time of the injury...

Ms. Kuan, 30~39 year old female. Ask Date: 2021/06/10

Dr. Wang Zhaomin reply Rehabilitation

The appearance of the injured area does not fully reflect the condition of the internal tissues, which varies depending on the individual's medical condition and the specifics of the surgical procedure.
A proper assessment of the actual situation requires an on-site examination.
Post-surgery, there will generally be some degree of restricted joint mobility, which can affect the overall experience.
To evaluate the extent of recovery or the possibility of re-injury, a professional physician should make the determination and arrange for appropriate examinations.
Online consultations cannot replace an in-person visit; please consult an orthopedic or rehabilitation specialist for an accurate diagnosis and to arrange suitable treatment options.

Reply Date: 2021/06/10

More Info

After undergoing traditional Achilles tendon repair surgery, it is not uncommon to observe some indentation or depression at the site of the injury. This can be concerning for patients, especially when they notice that the area appears similar to how it looked immediately after the injury. However, it is essential to understand that some degree of indentation can be a normal part of the healing process.

Understanding Post-Surgery Indentation
1. Healing Process: After surgery, the body goes through a complex healing process. Initially, there may be swelling and inflammation, which can obscure the true appearance of the tendon. As healing progresses, scar tissue forms, and the tendon may not return to its original shape. The indentation you see may be due to the formation of scar tissue, which can be less elastic than the original tendon tissue.

2. Expected Outcomes: While some patients may experience a return to a more normal contour over time, others may have a persistent indentation. Factors influencing this include the extent of the injury, the surgical technique used, and individual healing responses. It is important to have realistic expectations; complete restoration to the pre-injury state may not always be possible.

3. Physical Therapy: Engaging in a structured rehabilitation program is crucial for recovery. Physical therapy can help improve strength, flexibility, and overall function of the Achilles tendon. Your therapist can provide exercises that promote healing and may help in reshaping the tendon area over time.

Signs of Complications
To determine if there has been a re-rupture or any complications post-surgery, consider the following:
1. Pain and Swelling: While you mentioned not experiencing significant pain, it is essential to monitor for any sudden increase in pain, swelling, or bruising around the surgical site. These could be signs of complications.

2. Mobility and Function: If you notice a sudden loss of function, difficulty in walking, or an inability to bear weight on the affected foot, these could indicate a problem.
3. Physical Examination: Regular follow-up appointments with your surgeon are crucial. They will perform physical examinations to assess the integrity of the tendon and may use imaging studies, such as ultrasound or MRI, to evaluate the healing process.

4. Listening to Your Body: Pay attention to any unusual sensations or changes in the area. If you feel a sudden change in the area of the repair, such as a popping sensation or a return of significant pain, it is essential to contact your healthcare provider immediately.

Conclusion
In summary, some indentation at the site of an Achilles tendon repair can be normal, especially in the early stages of recovery. It is essential to follow your rehabilitation program and keep your healthcare provider informed of any changes in your condition. Regular check-ups will help ensure that your tendon is healing properly and that any potential complications are addressed promptly. If you have concerns about the appearance of your tendon or the healing process, do not hesitate to reach out to your surgeon for personalized advice and reassurance.

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