Achilles completely removed

I happen to be one of those people walking around WITHOUT an achilles tendon. I developed what looked to be a blister about the size of a dime along the incision at about 9 weeks post-op after ATR. The blister had some discharge but apparently it wasn’t enough of a concern for my Physical Therapist to send me back to my Ortho. The blister seemed to improve until about week 12 when the blister re-appeared with a vengeance. It became red around the blister and warm to the touch. I developed a low grade temperature and made an appt. with my Ortho. He sent me into surgery the same day for a debridement or “wash out“. After the procedure he told me that his original repair “looked good” and that the cultures taken from the area would be sent to infectious diseases lab for analysis. I began heavy antibiotics through IV and spent 4 days in the hospital. Lab results returned showing staph infection. Doc sent me home on antibiotics. The day I went home the wound site opened up again in the exact same area of the blister. Doc said that was to be expected and that it needed to heal from the inside out. 2 weeks later I was referred to a different Ortho and he could actually see the tendon hanging out of the back of my incision as well as the fiber stitches used in the original ATR repair. Surgery scheduled for same day for another “wash out“. After surgery I got the real bad news that the tendon was deteriorated to nothing but “GOOP” and “MUSH“. The tendon had to be removed completely. A wound vacuum was inserted into the wound for three days to aid in the closing of the wound as well as help any prevent any new infection. While staying in the hospital for 4 more days I continued to take heavy antibiotics through IV. After the 4th day the wound vac was removed and the wound was stitched up again. I am now healing without infection but will have to make a decision in the next three weeks about whether or not to undergo a fifth surgery to do a tendon transfer from my big toe(FHL tendon). The tendon is cut from under the big toe and re-routed through a hole that will be drilled through my heal bone and secured by a screw that goes through the bone as well. The tendon is then sewed up near the calf muscle and acts as the achilles. Wondering if I am the only sorry bastard that this has happened to? I am a 37 year old father of three who was playing volleyball with 10 year old’s when the ATR occurred.

16 Responses to “Achilles completely removed”

  1. Yep!!!!!

  2. Wow, that is really unlucky, I’m very sorry for you. Those of us having surgical repair all got the talk about the risks of infection being small, your story just reinforces they are small but real.
    It also reinforces that a PT is not a doctor, and if you have a concern about how the wound is looking or feeling, you should see doctor.
    Best of luck if you decide to go through with more surgery. I would be asking about the MRSA rates in the hospital you’re having your surgery at, as well as what prophylactic antibiotic you will be given. Also ask if it is safe to assume that you have fully cleared your previous staph infection.

  3. man…..that is not good!
    Thoughts are with you whatever you decide.

    Jon

  4. Ouch !!!

  5. I am so so sorry to hear this … please try not to give up hope … I’m sure the doctors will do a good job on the repair. If you decide to go for it, I really hope it goes well.

  6. Oh *&^%. I’m worried now as I have a opening in my wound that has been oozing and is quite sore. I have to go to the doc to get it dressed before my next appointment so I will definately get this seen to asap. You have my complete and utter sympathy…not that that’s what your after but thanks for making us all aware of the risks of what can happen. I think you have been extremely unfortunate so take care!

  7. I feel your pain. I had bilatheral ATR due to antibiotic side affect (Levaquin,Cipro). I had surgery to repair the rupture my right ankle but 7 month later there is no improvement. I have been told by another ortho doc that Ishould have the FHL procedure. I am debating ifI should have this surgery or wait.
    I have a 2 year old and can’t keep upwith her and it really gets frustrating. You are only 37 and young and should try to get as close to normal condition as possible. Do not give up hope and post an update on your surgery.

  8. OMG what a horror! I can’t imagine how I would handle that situation. I had the FHL transfer and by all accounts it went well. I’m at about 34 weeks post op. I was told that my repaired side would most likely be weaker than the normal leg. I havn’t returned to running yet but I’m cycling over 150 miles a week and walking has gotten a lot better.
    Your situation may be different due to the infection but my achillies was in pretty bad shape. IMHO there really is no choice but to have it done. If it goes well it should give you a great deal more functionality than if you forego it. At 37 you have a long road ahead of you. (I’m 57 btw) I had a great Foot & Ankle guy do my procedure at the Hospital for Special Surgery. I think selecting an Ortho who limits their practice to Foot and Ankle is the way to go when it’s a complicated procedure. Best of luck

  9. I would encourage you to have the FHL transfer. I had mine done in December. I believe that this procedure takes a little longer to get back to normal, but I feel really strong and everyday gets better and better. My surgeon has done of 200 of these and his patients are doing everything they did before. Be patient. Good luck no matter which way you go.

  10. orbitsmitty, I was reading your story and it is very similar to mine. If you would email me that would be great, I have some questions about the whole thing I would like talk to you about.

    Thanks,
    mikepants1@gmail.com

  11. My story is very similar:

    Rupture, repair, re-rupture, repair, skin damage due to the rapid surgeries, debridement surgery, wound vac, infection, surgery to remove mushy tendon, second surgery to completely clean out region, wound vac.

    My FHL transfer will be in 6 weeks or so…

  12. Sounds like I am going through with the same thing. ATR in November. Dime size wasn’t “connecting” and had a second surgery Dec 26th. Still doesnt look good and has been oozing and turning into a scab when dry. Now it is Feb 11th and lab results have come it to stay staph. I’m on antibiotics and have been for like 2 weeks, but this story is making me nervous. I will have to undergo a third surgery. I hope the repair is ok.

  13. Megan, all I’ve got is this : Last time I had an infection, the Docs took a culture and tested it in a culture, with a bunch of antibiotics. First time I’d had that done, but it’s a Great Thing. So then, when they prescribed Cipro (the “tendon-eater”), I could ask them what ELSE passed the culture test, and we went with THAT one! :-)

  14. Exact same situation as orbitsmitty except for the natural re-attachment. Need to decide on a repair with a toe tendon or cadaver achillies. My question is for those who got the reconstruction surgery 3-6 weeks after staph. My doctor said to wait 3-6 months; but I’m worried about my calf muscle degenerating before then.

  15. I had a lmost the same situation. My dr told me it would be at least 6 month to 9 months before another surgery should take place for the tendon transplant. However not sure I want to risk another surgery, almost lost my foot and ankle to infection. Just wondering how you are doing and which path you took.

  16. My son is going thru the exactly the same thing now. Everything you described is happening, He is scheduled to have the nerve from the big toe to rep-lace the Achilles tendon they removed. This is from 2009. I am wondering if the operation worked and how you are today.

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