Acute tears of the Achilles tendon can be managed with a cast or cast boot together with rehabilitation. However, a repair can possibly restore function more quickly, give more power in the healed tendon and also likely have less chances of a rerupture or retear. Previously, the main concern with a repair would be wound complications as a relatively long wound would be required for repair. Dr Tan has been using a minimally invasive technique for repairs for many years now and this has so far given a reliable repair without wound complications. With small wounds for the repair, this also allows faster rehabilitation without the use of a cast and also earlier weight bearing on the foot.
Chronic or missed Achilles tears are not that infrequent. In many cases, the original tear may have not been diagnosed immediately due to a variety of reasons. Many patients end up with a tendon that is torn and a relatively large gap between the tendon ends. This would traditionally require a fairly complicated reconstruction involving a significant wound/incision and use of local tendon flaps or a nearby tendon (tendon transfer eg, flexor hallucis longus [FHL] transfer) to bridge the gap. Recently, Dr Tan has been using an arthroscopic technique to perform a minimally invasive tendon reconstruction of chronic tears. This has the advantage of minimal wound complications and less concern for complications.