Houston Methodist. Leading Medicine

Foot FAQ


We had a Japanese exchange student live with us this summer. Just before his trip to the U.S., he ruptured his Achilles' tendon playing a game called sepaktakraw (kick volleyball). Two weeks after surgery, he was wearing a removable brace and putting full weight on his foot. Our son had this same surgery last year. He was in a cast for eight weeks. Do the Japanese have a different treatment for this injury?


For years, surgeons around the world have used a standard operation to repair an acute Achilles' tendon rupture. This procedure uses stitches called Kessler sutures. The operation must be followed by nonweight-bearing and limited range of motion. The patient must carry out this protocol for at least four to six weeks.

But several studies using modified suturing and surgical techniques have been reported. Using more stitches gives a stronger repair. It also allows for faster recovery. Earlier motion and full weight-bearing are possible much sooner than with the Kessler sutures.

Much of this new research is being done in Japan. The latest study reported accelerated results using a method that can adjust the tension on the tendon using a Tsuge suture at one end and a single knot at the other. Your exchange student may have benefitted from the expertise at one of these centers. Eiji Uchiyama, MD, et al. A Modified Operation for Achilles Tendon ruptures. In The American Journal of Sprts Medicine. October 2007. Vol. 35. No.10. Pp. 1739-1743.

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