Achilles Tendon Repair

1. DIET

• Begin with clear liquids and light foods (Jell-o, soups, etc.)
• Progress to your normal diet if you are not nauseated

2. WOUND CARE

• Maintain your operative splint/dressing
• It is normal for the knee to bleed and swell following surgery – if blood soaks onto the bandage, do not become alarmed – reinforce with additional dressing.
• Do NOT remove splint until you return for post-operative appointment
• Splint must be kept clean and DRY
  • ***If splint becomes wet please call office for evaluation***

3. MEDICATION

• *Do not drive a car or operate machinery while taking the narcotic medication*
• Pain medication is injected into the wound and knee joint during surgery – this will wear off within 8-12 hours.
• Most patients will require some narcotic pain medication for a short period of time.
• Primary Medication = Oxycodone
  • Take 1 – 2 tablets every 4 – 6 hours as needed
  • Max of 12 pills per day
  • Plan on using it for 2 to 5 days, depending on level of pain
• Common side effects of the pain medication are nausea, drowsiness, and constipation – to decrease the side effects, take medication with food.
• If constipation occurs, consider taking an over-the-counter laxative such as prune juice, Senekot, Colace (or Periocolase), or Miralax.
• If you are having problems with nausea and vomiting, contact the office to possibly have your medication change, call Dr. Howard’s office.
• For nausea, take prescribed Zofran / Phenergan.
• Ibuprofen 600-800mg (i.e., Advil) may be taken in between the narcotic pain medication to help smooth out the postoperative “peaks and valleys”, reduce overall amount of pain medication required, and increase the time intervals between narcotic pain medication usage.

4. ACTIVITY

• MUST USE CRUTCHES to maintain NON-WEIGHT BEARING
• Elevate the operative leg to chest level whenever possible to decrease swelling.
• Do Not place pillows under knees (i.e., do not maintain knee in a flexed or bent position), but rather place pillows under foot/ankle to elevate leg.
• Do not engage in activities which increase pain/swelling (prolonged periods of standing) over the first 7-10 days following surgery.
• Avoid long periods of sitting (without leg elevated) or long distance traveling for 2 weeks.
• May return to sedentary work ONLY or school 1 week after surgery, if pain is tolerable.

5. BRACE/SPLINT

• Post-op splint must be worn at all time
• Please keep splint clean and dry.
  • ***If splint becomes wet please call office for evaluation***

6. ICE THERAPY

• Begin immediately after surgery
• Use icing machine continuously or ice packs (if machine not prescribed) every 2 hours for 20 minutes daily until your first postoperative visit – remember to keep leg supported while icing

7. EXERCISE

• Begin exercises 24 hours after surgery (straight leg raises, quad sets, heel slides and ankle pumps) unless otherwise instructed.
• Discomfort and knee stiffness is normal for a few days following surgery
• Formal physical therapy (PT) will begin approximately 6 weeks after surgery. Please contact you PT location of choice after surgery to schedule appointments

8. EMERGENCIES

• Contact Dr. Howard or his staff at 831-648-7200 if any of the following are present:
  • Painful swelling or numbness
  • Unrelenting pain
  • Fever (over 101° - it is normal to have a low grade fever for the first day or two following surgery) or chills
  • Redness around incisions
  • Color change in wrist or hand
  • Continuous drainage or bleeding from incision (a small amount of drainage is expected)
  • Difficulty breathing
  • Excessive nausea/vomiting
• **If you have an emergency after office hours or on the weekend, contact the same office number ( and you will be connected to our page service)
• **If you have an emergency that requires immediate attention, proceed to the nearest emergency room.

9. FOLLOW UP CARE + QUESTIONS

• Typically the first post-operative appointment following surgery is 10-14 days following surgery
• If you do not already have a postoperative appointment scheduled, please contact the office during normal office hours (831-648-7200) and ask for appointment scheduling.
• The first post-operative appointment will be with Dr. Howard where he will assess the wound, go over post-operative protocol, and answer any questions you may have regarding the procedure