Understanding achilles tendon ruptures

Written in association with: Mr Efstathios Drampalos
Published:
Edited by: Kate Forristal

The Achilles tendon, named after the Greek mythological hero Achilles, is a vital component of the human body's locomotor system. Situated at the back of the calf, this robust band of tissue connects the two muscles in the calf to the heel bone. Its primary function is to facilitate plantar flexion, allowing movements such as running, walking, and jumping. Despite its strength, the Achilles tendon is susceptible to injury due to its relatively poor blood supply, which affects its healing process. In his latest online article, Mr Efstathios Drampalos gives us his insights.

Causes of rupture

Achilles tendon ruptures typically occur when a sudden and excessive force is applied to the tendon, often during activities like jumping or pivoting. This traumatic event is often accompanied by a distinctive "pop" sensation. It's important to note that a healthy tendon is more resilient to rupture; however, pre-existing conditions such as tendonitis or degeneration can weaken the tendon, making it more prone to injury.

 

Several factors increase the risk of Achilles tendon damage or rupture, including overuse, improper running technique, advancing age, autoimmune diseases, obesity, and certain medications. Antibiotics and corticosteroids, in particular, can elevate the risk of tendonitis, predisposing individuals to ruptures.

 

Treatment options

When faced with an Achilles tendon rupture, treatment options typically involve either surgical intervention or non-surgical approaches. Surgical repair may entail open or minimally invasive procedures, sometimes necessitating the repositioning of another tendon, such as the flexor hallucis longus tendon, to support the Achilles tendon. Recovery from surgical repair can take upwards of 24 weeks before full function is restored.

 

Traditionally, Achilles tendon ruptures were managed through either surgery or complete immobilisation of the leg for approximately two months. While surgery was believed to offer superior outcomes, it carried inherent risks, including wound healing complications and infections, with reported rates as high as 20-30% in some studies.

 

Advancements in rehabilitation

In recent decades, the landscape of Achilles tendon rupture treatment has evolved significantly. The introduction of early rehabilitation protocols has revolutionised rehabilitation strategies by enabling early mobilisation and weight-bearing activities. Large-scale studies have demonstrated that these protocols are as effective as surgery in promoting recovery while mitigating the risks associated with surgical interventions.

 

As part of the management of Achilles tendon injuries, patients are typically prescribed an early rehabilitation protocol tailored to their specific condition. While the specifics may vary, the overarching goal remains consistent: to optimise healing, restore function, and minimise the risk of complications.

 

Mr Efstathios Drampalos is an esteemed orthopaedic surgeon. You can schedule an appointment with Mr Drampalos on his Top Doctors profile.

By Mr Efstathios Drampalos
Orthopaedic surgery

Mr Efstathios Drampalos is a distinguished consultant orthopaedic foot and ankle surgeon currently practising as the Chief Foot and Ankle Consultant at Forth Valley Royal Hospital and at Circle Health Group Kings Park Hospital. He is an experienced orthopaedic surgeon with a special interest in all aspects of foot and ankle surgery. He worked at Manchester University NHS FT from 2018 to 2019 as an Orthopaedic Foot and Ankle/Limb Reconstruction Consultant before moving to Scotland. His areas of expertise include complex bunion correction, ankle arthritis, ankle arthroscopy, and foot and ankle sports injuries. He also treats flatfoot, high arch and Achilles tendonitis using boyh open or minimal invasive surgery (MIS) techniques.

With over two decades of experience in different health systems in Europe, his commitment to advancing orthopaedic care is evident in his comprehensive skill set, making him a trusted professional in the field. In addition to the above areas of expertise, he has a special interest in heel pain and plantar fasciitis, platelet-rich plasma injections (PRP), big toe replacements and fusion surgery, fractures, bone infections and toe deformities.

Mr Drampalos has pursued an impressive academic journey. He first qualified with an MD from the University of Bologna in Italy with first-class honours and distinction (110/110 e lode), before going on to receive further prestigious qualifications. He completed training in Orthopaedic Surgery in the major orthopaedic centres of Athens, obtaining an FRCS (Trauma & Orthopaedics) equivalent title and a Certificate of Completion of Training (CCT) in Trauma & Orthopaedics in 2013, developing a special interest in foot and ankle surgery. In 2013 obtained the European Board of Orthopaedics and Traumatology certification in Barcelona (FEBOT). He holds both a PhD and MSc in Orthopaedics. As an Honorary Senior Clinical Lecturer at the University of Glasgow Medical School, Mr Drampalos also contributes to the education and training of future medical professionals.

He completed two prestigious fellowships of the Wrightington Elective Centre in the Greater Manchester Area (foot and ankle surgery and lower limb reconstruction), specialising in treatment of sport injuries, arthritic conditions of foot and ankle and total hip/knee arthroplasty, and then the fellowship of Wythenshawe Hospital (Manchester) with a focus on complex trauma, Ilizarov techniques and bone infections as a member of the Ortho-Plastic Team. He also treated diabetic foot problems as the Orthopaedic Surgeon of the famous multidisciplinary Diabetic Foot Team of Greater Manchester and has completed a one-year BOA National Clinical Leader Programme.

He has undertaken further specialist training in ankle replacement and foot deformity correction with leading European foot and ankle surgeons including the foot and ankle fellowship of Stepping Hill Hospital in Manchester, a visiting fellowship at CFR Hospitaler A/S, Hellerup, Denmark. Furthermore, he has completed a fellowship in Ilizarov techniques and limb deformity correction at the renowned Mediclinic Midstream, Pretoria, in South Africa. Mr Drampalos has also completed a visiting fellowship in minimal invasive surgery (MIS) for foot conditions in Brighton and Sussex University Hospitals.

In addition to his clinical expertise, Mr Drampalos is actively engaged in research, as evident by his numerous publications. He has published more than 40 articles in international peer-reviewed journals, 2 books and more than 60 presentations and abstracts in congresses. He is running several research programmes at Forth Valley Royal Hospital. Internationally he runs research programmes with the Biomedical Engineering Department of the University of Sakarya and the Medical School of Medipol University (Turkey). He is an editorial board member and reviewer for several international peer-reviewed journals and has completed several audits and quality improvement projects for the NHS improving the delivery of care and preserving resources. His commitment to advancing knowledge in orthopaedics has been recognised with the Scholarship Prize from the Hellenic Society of Orthopaedic Surgery and Traumatology in 2012.

As a member of esteemed organisations such as the British Orthopaedic Association and the European Board of Orthopaedic and Traumatology, Mr Drampalos upholds the highest standards of professional practice. Fluent in English, Greek, and Italian, he ensures effective communication with a diverse patient population. With a dedication to patient care, education, and advancing the field of orthopaedics, Mr Efstathios Drampalos stands as a respected and accomplished healthcare professional.

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