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Achilles Tendon Rupture — Ankle Minimally Invasive Surgery: treatment in the Best Hospitals of Germany

St. Vinzenz Hospital for Orthopedics Duesseldorf

9.9/10
location_onGermany, Duesseldorf

Department of Adult and Pediatric Orthopedics, Foot Surgery

The Department of Adult and Pediatric Orthopedics, Foot Surgery offers the widest range of modern medical services to patients suffering from musculoskeletal diseases. The department specializes in knee and hip replacement surgery, including revision interventions to replace previously implanted artificial joints. The department has the status of a certified Maximum Care Endoprosthetics Center (endoCert), which means adherence to the requirements of European professional societies for carrying out procedures of this kind, a high level of safety and treatment efficiency. It is worth noting that the department uses the innovative ROSA® robotic system for performing knee replacement surgery. A special Rapid Recovery Program is used for the rapid recovery of mobility after joint surgery, which allows the patients to quickly return to their usual life. An integral part of the department's clinical practice is also the treatment of foot diseases and deformities in adults and children. The medical facility has been operating for more than 50 years, and therefore it provides patients with the highest quality medical care and easily copes even with highly severe pathologies.

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Vitos Orthopedic Clinic Kassel

9.2/10
location_onGermany, Kassel

Department of Adult and Pediatric General Orthopedics, Trauma Surgery

The Department of Adult and Pediatric General Orthopedics, Trauma Surgery offers the full range of diagnostics and treatment of musculoskeletal pathologies. The specialization covers joint replacement surgery, foot and hand surgery, shoulder surgery, treatment of rheumatic joint lesions, treatment of injuries, sports orthopedics, treatment of orthopedic problems in children and adolescents, as well as pain therapy. The key to successful clinical practice is the highest professionalism and unique experience of the department's medical team combined with the very latest infrastructure and advanced equipment.

University Hospital Ulm

9.2/10
location_onGermany, Ulm

Department of Adult and Pediatric Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics ranks among the top German departments specializing in joint replacement surgery! The department covers the full range of conservative and operative therapy in diseases of the musculoskeletal system, including the special pain therapy in the case of these pathologies, emergency treatment and long-term care for the patients with paraplegia. The department offers many sparing minimally invasive techniques, advanced navigation systems for high-precision interventions.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Adult and Pediatric Orthopedics, Special Orthopedic Surgery and Rheumatic Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics, Special Orthopedic Surgery and Rheumatic Orthopedics ranks among the top German medical facilities specializing in the treatment of orthopedic diseases in adults and children, as well as in hip surgery! The department offers the full range of medical services in these medical fields. It carries out both diagnostics and treatment of patients of all age groups, including very elderly patients, with various musculoskeletal diseases. The therapeutic options include both conservative and surgical treatment methods. The department is distinguished by high professionalism of doctors, advanced infrastructure and invaluable experience in the field of its specialization, due to which it occupies leading positions in the European medical arena and guarantees an optimal treatment result.

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Adult and Pediatric Orthopedics, Traumatology

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics, Traumatology ranks among the top German departments specializing in endoprosthetic joint replacement! The department offers the full range of services in the field of diagnostics and treatment of all diseases of the musculoskeletal system. In addition to surgical treatment, a number of effective conservative treatments are available in the department, for example, physiotherapy, occupational therapy, therapeutic exercise. The highly qualified doctors who have a rich experience and outstanding treatment results take care of the patients' health. 

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Adult and Pediatric Orthopedics, Foot Surgery

The Department of Adult and Pediatric Orthopedics, Foot Surgery offers the full range of services for the diagnostics and treatment of musculoskeletal diseases: bone, joint, muscle, ligament and tendon diseases. Special attention in the department's clinical practice is paid to knee and hip replacement surgery, including revision interventions to replace previously implanted prostheses, treatment of foot diseases, musculoskeletal cancers, orthopedic diseases in children. In addition, the department's specialists deal with the treatment of rare and especially complex musculoskeletal diseases. The department's highly specialized medical team applies only modern diagnostic and therapeutic techniques in their practice, and the long-term experience of doctors guarantees top-class surgical and conservative treatment. As a certified Maximum Care Endoprosthetics Center, the department's doctors annually perform more than 1,000 surgical procedures for partial and total joint replacement. Every year, more than 10,000 patients entrust their health to the department's medical team. Whenever required, doctors from related medical specialties are involved in the treatment process. The main goal and focus of doctors is to maximally restore the patient's health and give him the opportunity to return to his usual way of life.

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Adult and Pediatric Orthopedics

The Department of Adult and Pediatric Orthopedics is the center of maximum orthopedic care and offers the diagnostics and treatment of all diseases and injuries of the musculoskeletal system. Along with the full range of modern operative and conservative orthopedics, the department specializes in hip and knee replacement surgery using the minimally invasive methods, replacement/revision of prostheses, orthopaedic oncology, foot surgery and patella problems in the patella.

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery

The Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery offers the full range of diagnostics, conservative and surgical treatment of musculoskeletal diseases and injuries. The department is a certified Endoprosthetics Center – more than 1,000 primary joint replacement surgeries are performed here annually. The surgeons of the Endoprosthetics Center also specialize in particularly complex clinical cases and revision procedures for the replacement of previously implanted artificial joints. In addition, the department has the status of the interregional Trauma Center certified in accordance with the standards of the German Trauma Society. The department has also been awarded a Certificate of Excellence from the German Orthopedic Foot and Ankle Society (DAF) in the field of foot surgery. A separate area of ​​clinical activity is the treatment of diseases, injuries and congenital malformations of the musculoskeletal system in children. Depending on the severity of the clinical case, both conservative and surgical techniques are used in the treatment of orthopedic pathologies in children. The department's medical team prefers sparing low-traumatic surgery, while open operations are performed only if other therapeutic options are ineffective.

University Hospital Tuebingen

9.2/10
location_onGermany, Tuebingen

Department of Adult and Pediatric Orthopedics

The Department of Adult and Pediatric Orthopedics offers the full range of modern diagnostics and treatment of diseases, deformities of the musculoskeletal system in patients of all age groups. The priority task of all specialists of the department is to preserve the mobility of the patient and improve the quality of his life. In the field of surgical treatment, the main focus is on joint arthroplasty, resection of musculoskeletal tumors, as well as surgical correction of spinal defects and pathologies. In addition, the department specializes in the treatment of sports injuries.

University Hospital Muenster

9.8/10
location_onGermany, Muenster

Department of General Orthopedics and Orthopedic Oncology

The Department of General Orthopedics and Orthopedic Oncology offers the full range of conservative and surgical treatment of all musculoskeletal diseases. The department ranks among the largest medical facilities of this kind in Germany, as well as among the specialized authoritative departments for the treatment of bone and soft tissue tumors in the European medical arena. The treatment is carried out both on an outpatient and inpatient basis, including the outpatient operations. In addition to its successful clinical activities, the department is proud of its productive research work, which has given birth to many innovations in orthopedics, for example, the department's specialists have patented the very latest prosthetic systems, particularly in the field of orthopedic oncology.

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of Adult and Pediatric Orthopedics, Foot Surgery

The Department of Adult and Pediatric Orthopedics, Foot Surgery carries out accurate diagnostics, effective conservative and surgical treatment of the full range of diseases of the musculoskeletal system. The department's medical team's responsibilities also include physiotherapy and rehabilitation activities. Surgery for orthopedic diseases is performed in state-of-the-art operating rooms equipped for sparing minimally invasive and arthroscopic interventions. There are also treatment rooms for physiotherapy, including a room with a pool for swimming and physical exercises in the water, and rooms with modern exercise equipment. The excellent infrastructure allows doctors to provide high-quality treatment of diseases of the joints, tendons, and bones, thereby restoring patient mobility as quickly as possible. The department admits patients of all age groups, including children and adolescents. The medical facility has been awarded many prestigious quality certificates, including DGOU, endoCert, and EPRD certificates, and has an impeccable reputation in Germany.

University Hospital RWTH Aachen

8.5/10
location_onGermany, Aachen

Department of Adult and Pediatric Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics ranks among the top German medical facilities specializing in joint replacement surgery! The department offers the full range of diagnostics and treatment for patients with musculoskeletal diseases. The department treats patients of all age groups ranging from young children to elderly people. The department annually treats more than 15,000 patients, and also performs about 1,500 interventions yearly. The department has long traditions, long successful clinical experience, which contributes to its reputable status in the medical arena.

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Orthopedics and Traumatology

According to the Focus magazine, the Department of Orthopedics and Traumatology ranks among the top German medical facilities specializing in the treatment of injuries of any severity! The department offers the full range of diagnostic and therapeutic services to patients with diseases and injuries of the musculoskeletal system. The department has been certified by the German Society of Traumatology as a supra-regional Trauma Center. In addition, the medical institution is a certified Center for Gerontological Traumatology, the Center for Arthroscopy and Joint Surgery.

University Hospital Jena

8.9/10
location_onGermany, Jena

Department of Adult and Pediatric Trauma, Hand, Reconstructive Surgery

The Department of Adult and Pediatric Trauma, Hand, Reconstructive Surgery offers all modern surgical interventions in these medical fields. The department specializes in the treatment of patients with polytrauma, pelvic surgery, endoprosthetics, cancer, reconstructive surgery and hand surgery. The department has 62 beds for inpatient treatment and 3 high-tech operating rooms for both planned and emergency operations. The prestigious certificates of the Interregional Trauma Center of the German Society of Traumatology and the EndoCert certificate testify to the outstanding quality of medical services.

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Orthopedics, Trauma and Reconstructive Surgery

The Department of Orthopedics, Trauma and Reconstructive Surgery offers the full range of modern diagnostic examinations, conservative and surgical treatment of the musculoskeletal system. The competence also includes round-the-clock medical care for patients with severe and multiple injuries. The department operates a certified Endoprosthetics Center, within which the patients undergo knee, hip and shoulder replacement surgeries. All the department's doctors have excellent qualifications and they are recognized experts in their field of competence, which guarantees the highest quality of medical service.

University Hospital Duesseldorf

9.5/10
location_onGermany, Duesseldorf

Department of Adult and Pediatric Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics ranks among the top German departments specializing in joint replacement surgery! The department offers the full range of diagnostics and treatment of various diseases, injuries of the musculoskeletal system, and their consequences. Also, the department's doctors specialize in sports orthopedics and treatment of orthopedic diseases in children of all age groups. The doctors have in their arsenal many conservative and surgical treatment methods. Many complex operations are carried out using a highly accurate computerized system

An Achilles tendon rupture causes ankle pain, tissue swelling, and ankle joint dysfunction. In most cases, this injury requires surgery. To repair the ligament, German surgeons most often use Achilles tendon suturing or plastic surgery. Doctors in this country perform minimally invasive surgery to reduce the risk of complications and accelerate the recovery of the patient.

Content

  1. Why is surgical treatment better than a conservative one?
  2. What operations are used for Achilles tendon injury
  3. Achilles tendon suturing
  4. Achilles tendon plastic surgery
  5. Why is it worth undergoing treatment in Germany?

Why is surgical treatment better than a conservative one?

 

Until the end of the 20th century, there were discussions about what is better: conservative management of patients or surgical intervention. However, since the late 80s, surgical tactics began to dominate, and in the 90s, dominance became total. In the 21st century, operations for Achilles tendon rupture are becoming more sparing, safe, and less traumatic. Therefore, conservative treatment is used extremely rarely.

Conservative tactics are attractive in that they have a low risk of complications. It is not characterized by surgical risks: there are no infections, damage to other tendons, nerves, wound healing problems, etc. In the 20th century, these advantages were relevant since the operations were traumatic, and the risk of complications reached 25%.

However, there has never been any doubt that surgical treatment of the Achilles tendon is more effective than conservative treatment. Conservative tactics include long-term limb immobilization for up to 2-3 months. During this time, muscle atrophy occurs, and degenerative changes in the Achilles tendon are possible. As a result, every third person has a repeated rupture.

After a well-performed surgical procedure, the risk of recurrent Achilles tendon rupture is only 2%. This treatment method is more reliable. The operations are especially successful if they are performed within the first ten days of injury. Good results are achieved in the first three weeks. After this time, the Achilles tendon rupture is considered chronic, and it is more complex to treat.

What operations are used for Achilles tendon injury

 

The Achilles tendon can be repaired using various techniques. Acute Achilles tendon injury is most commonly treated with suturing. In case of chronic injuries, doctors resort to plastic surgery. However, these terms hide dozens of different types of operations. There are more than 80 types of Achilles suturing techniques and more than 40 types of plastic surgery.

There are the following types of surgical techniques for Achilles tendon rupture:

  • open – classical interventions through a large incision in the ankle;
  • percutaneous – minimally invasive closed interventions, without or with ultrasound guidance;
  • endoscopic minimally invasive surgery – under the guidance of an endoscope (the doctor controls his actions, focusing on the images transmitted by a mini video camera).

The easiest way to repair the calcaneal tendon is during open surgery. The doctor can reliably see the tendon and sutures it with a low risk of damaging healthy tissue. However, such interventions are traumatic and require a long recovery. Their problem is the high risk of infectious complications. A large unaesthetic scar is formed in the area of ​​the incision on the ankle.

Minimally invasive surgery is more complex, but it is safer and more sparing. Therefore, German surgeons prefer the treatment of tendon rupture using percutaneous and endoscopic techniques.

Achilles tendon suturing

 

Suturing for acute Achilles tendon rupture remains the mainstay of treatment. Timely surgery allows for achieving excellent results. In the first two weeks, there are no degenerative changes in the rupture area yet. If signs of early degeneration or rupture of the torn Achilles tendon are detected, ligament plastic surgery is preferable.

The suturing can be performed using different techniques:

  • open surgery;
  • the closed percutaneous technique (suturing with a needle inserted into the Achilles tendon);
  • minimally invasive surgery under endoscopic guidance.

The closed method of suturing with buried sutures was developed back in 1977. It is minimally traumatic, and the procedure can be performed even on an outpatient basis. However, in the classical version, this procedure for the Achilles tendon rupture has not become widespread. The reason is the lack of image guidance. The doctor does not see what he is suturing and whether he is doing it well. In addition, there is a risk of damage to the adjacent nerves. As a result, the sutures often fail after the procedure, and the calcaneal tendon is ruptured again.

However, modified versions of percutaneous techniques are successfully used in the 21st century. To control the procedure, doctors began to use ultrasound scanning. In addition, special guides and suturing devices appeared. Doctors can accurately bring together and suture the ends of the Achilles tendon through an incision only 1 cm long: quickly, reliably, and with minimal trauma rate.

German hospitals also perform minimally invasive endoscopic surgery. They are performed through 1-2 cm incisions. Doctors use a mini video camera with lighting to control their actions. Endoscopic guidance provides reliable surgery outcomes with a low risk of complications.

Minimally invasive surgery on the Achilles tendon benefits the patient's recovery. It creates the prerequisites for early mobilization and the start of rehabilitation measures. As a result, the person has less muscle atrophy and less risk of ankle stiffness. Patients quickly return to everyday life and maximum loads, which is especially important for professional athletes.

Achilles tendon plastic surgery

 

Plastic surgery involves strengthening the calcaneal tendon with additional materials: biological or synthetic ones. This type of Achilles tendon surgery is used for chronic injuries. In addition, plastic surgery is performed in case of acute Achilles tendon rupture, which is accompanied by dissociation of the Achilles tendon.

The following materials can be used for plastic surgery:

  • autograft – a fragment of the tendon, usually from the lower extremity, including from the upper part of the Achilles tendon;
  • allograft – a preserved donor tendon;
  • xenograft – a tendon of animals;
  • synthetic materials.

The calcaneal tendon is most often restored with the patient's own tissues. They are characterized by good engraftment and provide normal foot function. After autoplasty, the blood supply to the Achilles tendon is better. The risk of recurrent rupture is negligible. This treatment method allows doctors to get the strongest tendon compared to other plastic surgery techniques. It is ideal for athletes and young people engaged in physical labor. After surgery and rehabilitation, the patient can withstand any load on the foot. However, this option has a drawback: the intervention is more traumatic since, in addition to the Achilles tendon, the doctor also has to operate on another tendon.

Alloplasty is another option for Achilles tendon repair. The surgical intervention ensures complete restoration of the function of the foot. Donor tendons are processed to minimize the risk of immune reactions and stored for a long time in preserved form. As a result, they become less durable than a native human tendon. After this surgery, the maximum sport load on the foot has a higher risk of recurrent rupture. Therefore, the intervention is performed mainly in patients with low physical activity, or at least those with no extreme loads on the foot.

Synthetic materials are used less frequently for Achilles tendon plastic surgery. A foreign body in the organism can provoke an inflammatory reaction. However, bioinert materials have appeared in recent years and are strong enough. As a rule, their use does not cause any complications. The results of plastic surgery are comparable to the Achilles tendon repair with autologous materials.

Why is it worth undergoing treatment in Germany?

 

German orthopedists have a brilliant reputation all over the world. Athletes often come to Germany for treatment not only from countries with poorly developed medicine but also from economically prosperous states. Many patients want to use the services of the best specialists to recover minimally traumatically, without complications, and return to training and competition as soon as possible.

In Germany, you can count on:

  • minimally invasive techniques for performing operations through short incisions 1-2 cm long;
  • surgical intervention under endoscopic guidance;
  • minimal risk of complications;
  • reliable suturing of the Achilles tendon rupture: the risk of recurrent ligament tear will be the same as the probability of the primary rupture;
  • successful treatment even in the most complex cases: with dissociation of the Achilles tendon, concomitant injuries of the lower extremity, chronic injuries, and recurrent tendon rupture.

To undergo surgical treatment of Achilles tendon injuries in Germany, please use the Booking Health service. On our website, you have the opportunity to get up-to-date and accurate information about the cost of treatment in Germany, compare prices in different German hospitals and book a medical care program at a favorable price. The treatment will be easier and faster for you, and the cost of treatment in Germany will be lower.

You are welcome to leave your request on the Booking Health website. Our employee will contact you, consult, and answer all questions. We will take care of the organization of your trip abroad. We will provide the following benefits for you:

  • We will select the best German hospital whose doctors specialize in minimally invasive Achilles tendon repair and achieve the best results.
  • We will help you overcome the language barrier and establish communication with the doctor in the German hospital.
  • We will reduce the waiting period for tendon rupture treatment, and you will receive medical care on the most suitable dates.
  • We will reduce the price. The cost of treatment in Germany for tendon rupture will be lower than usual due to the lack of overpricing and coefficients for foreign patients.
  • Our specialists will solve any organizational issues: paperwork, transfer from the airport to the German hospital and back, hotel booking, and interpreting services.
  • We will prepare your documents and translate them into English or German. You do not have to undergo previously performed diagnostic procedures.
  • We will keep in contact with the German hospital after completing the tendon rupture treatment.
  • We will organize additional diagnostics and treatment, if necessary.
  • We will buy medicines in another country and forward them to your native country.

While the best specialists in the world take care of your health, the Booking Health staff will help reduce the cost of treatment in Germany and take care of all your travel arrangements.

 

Authors: 

The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

 

Sources:

MedlinePlus

Medscape

Cochrane Rehabilitation




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