Heal Thyself: Most who tear Achilles tendon can skip surgery

New research suggests that surgery may not be needed for most Achilles tendon tears

LONDON -- It’s a weekend warrior’s nightmare. You’re playing hoops in the driveway and go up for a lay-up. You land and hear a pop: you’ve torn your Achilles tendon. Do you have surgery or hope it heals with just a cast and rehab? New research says both options led to similar outcomes about a year later.

The Achilles tendon, which connects the muscles in the back of the calf to the heel bone, is the most commonly torn tendon in the body. Most tears are due to trauma or accident while playing sports; men are much more prone to the injury than women.

In the biggest-ever study investigating which treatment is best, scientists in Norway tracked 526 patients — mostly men with an average age of 39 — who ripped their Achilles tendon. They either had minimally invasive surgery, a standard surgery or non-surgical treatment, a brace to immobilize the affected foot and physical therapy. All patients got rehab therapy and were told to avoid risky activities for six months.

There were only slight differences in how everyone had recovered about a year later. There were more people who re-injured their Achilles tendon among those who didn’t have surgery — 6.2% versus 0.6% of those who had an operation. And there were more nerve injuries reported in those who had surgery. About 5% of those who had the minimally invasive surgery reported nerve injuries afterward, compared to 2.8% of those who had the standard surgery and 0.6% of those who skipped surgery. The study was published online Wednesday in the New England Journal of Medicine.