Dr. Öğr. Üyesi Görkem Kıyak
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Foot & Ankle
Achilles tendon repair
What Achilles tendon repair is, how a ruptured or degenerated tendon is stitched or reconstructed, what the evidence says about surgery against a boot and physiotherapy, approximate costs in Turkey against the UK, US and Germany, the week-by-week recovery, risks such as re-rupture and wound problems, and how to choose a surgeon.
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Achilles tendon repair in Turkey: what the operation is
Achilles tendon repair is surgery to restore a torn, ruptured or badly degenerated Achilles tendon, the thick cord that links the calf muscles to the heel bone and drives every step, jump and push-off. In an acute rupture the surgeon finds the two torn ends and stitches them together. In a long-standing tear or tendon wear the damaged part is cleaned out and the tendon is reinforced or rebuilt, sometimes with a neighbouring tendon (usually the one that flexes the big toe). Orthopaedic and sports-injury teams in Turkey perform both open and minimally invasive versions.
This guide explains when surgery is considered, how the techniques differ, what it costs against the UK, US and Germany, the recovery timeline and the risks. For other orthopaedic procedures see our orthopedics treatments in Turkey.
How do you know the Achilles tendon has ruptured?
A complete rupture is often sudden: a snap or a feeling of being kicked in the back of the calf during a push-off, a sprint, a jump or a change of direction, followed by pain, swelling and weak push-off. A gap may be felt above the heel and you cannot rise onto your toes on that leg. Doctors confirm it with the calf-squeeze (Thompson) test, ultrasound or MRI. Partial tears and tendinopathy build up slowly with pain, thickening and morning stiffness. Time matters: repair is easiest in the first days to weeks, before the tendon ends retract and scar.
Which techniques are used to repair the Achilles tendon?
- Open end-to-end repair. A 8 to 10 cm incision over the back of the leg, strong sutures in both ends and a tight knot. It gives the clearest view and is the traditional method.
- Minimally invasive or percutaneous repair. Small cuts and a suturing guide pass stitches through the skin. Wound problems are fewer; the sural nerve beside the tendon must be protected.
- Augmented repair or graft reconstruction. Used when the tendon is frayed, the gap is large or the injury is old. A tendon transfer, a turndown flap of the calf tendon or a graft bridges the defect.
- Debridement with reattachment. For insertional tendinopathy near the heel: bone spur and diseased tendon are removed and the tendon is anchored back to the heel bone.
The operation takes about 45 to 90 minutes under spinal or general anaesthesia, usually with the patient lying face down. The surgeon checks the tension by moving the ankle, so that the repaired tendon is neither too tight (which limits ankle movement) nor too slack (which weakens push-off). Before the wound is closed, the thin sheath around the tendon is repaired when possible, as this helps it glide and heal. You wake with the foot pointing slightly downwards in a splint, which keeps the repair under no tension.
Surgery or a boot: does Achilles tendon repair work better?
Large trials and reviews of acute ruptures show that modern non-surgical treatment (a boot with heel wedges, early protected weight-bearing and rehabilitation) can give results close to surgery. The main difference is the re-rupture rate: it is lower after surgery, while surgery carries its own risk of wound problems and infection. Surgery is more often advised for active people and athletes who want the strongest push-off, for ruptures that are diagnosed late, partial tears that do not respond, and tendons that have retracted. Orthopaedic bodies describe both routes as reasonable, so the decision should be made with the surgeon after an ultrasound or MRI rather than by default.
Achilles tendon repair cost in Turkey and why prices differ
The figures are approximate ranges per operation, not hospital quotes. The hospital confirms its price in writing after reviewing your scan.
| Country | Approximate cost range |
|---|---|
| Turkey | €2,500 – €6,500 |
| United Kingdom | €6,000 – €14,000 |
| United States | €10,000 – €30,000 |
| Germany | €5,000 – €12,000 |
The price depends on whether it is a simple end-to-end repair or a reconstruction with a graft or tendon transfer, the implants and anchors, the type of anaesthesia, the number of hospital nights, the time since the injury and the boot and crutches provided. Packages usually include pre-operative tests, surgery, the anaesthetist, one or two hospital nights, a boot or cast and airport transfers. Physiotherapy sessions back home are rarely included.
Who is a good candidate for Achilles tendon repair?
Surgery is considered for a complete rupture in an active person, a late-diagnosed rupture, a partial tear with persistent weakness, and chronic tendon disease that has failed physiotherapy, shockwave and injections. It is approached with caution if you smoke, have diabetes with poor circulation, have used fluoroquinolone antibiotics or steroid injections near the tendon (which weaken it), have an active skin problem over the heel, or are unfit for anaesthesia. For some older, less active patients a boot is the safer route. Your surgeon will also ask what you need the leg for: a person who walks, cycles and swims has different goals from a footballer or a runner, and the plan should match them.
Achilles tendon repair recovery: week by week
| Stage | What usually happens |
|---|---|
| Days 1 to 3 | One or two nights in hospital; leg raised, foot pointed down in a splint, no weight |
| Weeks 2 to 6 | Stitches out at around two weeks; a boot with heel wedges, gradually lowered; protected weight-bearing from the surgeon's go-ahead |
| Weeks 6 to 12 | Boot removed; physiotherapy to regain ankle movement and calf strength |
| Months 3 to 6 | Walking normally; calf-raise strength rebuilt; jogging may start |
| Months 6 to 12 | Return to sport and jumping, depending on strength tests |
Protocols differ between surgeons, and many now allow earlier loading in a boot. Most patients stay in Turkey for 5 to 7 days: enough for the first check and a boot adjustment. Flying is normally fine afterwards with the leg raised and clot-prevention advice. The long phase is rehabilitation, so arrange a physiotherapist at home before you travel.
What results can you expect, and when can you run again?
Most people regain full walking and daily activity. Calf strength and push-off power may stay a little below the other leg, and the repaired tendon often looks thicker. Return to running is usually from about four to six months and to sports with jumping or sprinting from six to twelve months, once strength tests are close to the healthy side. A published before-and-after photo of a repaired tendon shows only a scar and a thicker area; the real result is how the calf performs, so ask the surgeon how return to sport is tested. Typical tests are single-leg calf raises, hop tests and a comparison of strength between the two legs. Be realistic about age and training level: a recreational player returns to a good level, but no clinic can promise a return to the same peak performance as before the injury.
Risks and complications of Achilles tendon repair
Risks include wound healing problems and infection (higher in smokers and people with diabetes, and with open repair), nerve irritation or numbness on the outer foot, thickened scar, blood clots (deep vein thrombosis), stiffness or calf weakness and re-rupture. The NHS and orthopaedic societies such as the American Academy of Orthopaedic Surgeons (AAOS) describe these risks and note that re-rupture is uncommon but real, particularly when loading starts too early. Following the rehabilitation plan is the best protection. Ask the hospital how a wound problem would be handled after you leave Turkey.
How to choose a surgeon and hospital, and questions to ask
Choose an orthopaedic surgeon who works regularly with foot, ankle and sports injuries in an accredited hospital with an anaesthetist and a physiotherapy team, and expect a written plan and price after your MRI or ultrasound has been reviewed. Red flags: a quote without looking at the scan, a promise of a fixed return-to-sport date, no plan for rehabilitation and pressure to pay quickly. See how our process works and send your scans through our free quote page. Questions to ask:
- Open, minimally invasive or reconstruction, and why for my tendon?
- How long until I can put weight on the leg?
- What is your protocol for loading and return to sport?
- How many days must I stay in Turkey?
- Is the boot, crutches and follow-up included in the price?
- Who handles problems after I fly home?
Hospitals with Orthopedics in Turkey
Frequently asked questions
It is surgery to stitch or rebuild a torn or damaged Achilles tendon, the cord joining the calf muscles to the heel. It restores push-off strength and is done either through an open incision or through small cuts.
Yes, most people regain normal walking and often return to sport. Surgery lowers the risk of re-rupture compared with a boot alone, though modern non-surgical care can give similar results in many people.
Approximate ranges are €2,500 to €6,500 in Turkey, against about €6,000 to €14,000 in the UK. A tendon transfer or graft costs more than a simple repair; the hospital confirms its price in a written quote.
Not always. Trials show similar function for many patients, with fewer re-ruptures after surgery but a risk of wound problems. Surgery is more often advised for athletes and late-diagnosed or retracted tears.
Most people are in a boot for 6 to 8 weeks, walk normally by about three months and return to running from four to six months. Return to jumping sports can take up to a year.
The operation is done under anaesthesia and a nerve block often eases the first hours. Afterwards the calf and heel are sore and swollen for a week or two, usually controlled with prescribed painkillers and elevation.
You walk with crutches and no weight at first, then put weight on the foot in a boot from roughly two to six weeks depending on the surgeon's protocol. Normal shoes follow after about 8 to 12 weeks.
Re-rupture is uncommon but possible, especially if loading starts too early or the tendon was degenerated. Following the rehabilitation plan and avoiding sudden push-off early on lower the risk.
The main risks are wound healing problems, infection, nerve numbness on the outer foot, blood clots, stiffness and re-rupture. Smoking and diabetes raise the chance of wound problems.
Plan for about 5 to 7 days, including one or two hospital nights and a first check and boot adjustment. Rehabilitation continues at home with a local physiotherapist.
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