Achilles tendon rupture vestigial muscle is harvested and wrapped around the Achilles tendon, increasing the strength of the repaired tendon. If the tissue quality is poor, e.g. the injury has been neglected, the surgeon might use a reinforcement mesh (collagen, Artelon or other degradable material). In percutaneous surgery, the surgeon makes several small incisions, rather than one large incision, and sews the tendon back together through the incision(s). Surgery may be delayed for about a week after the rupture to let the swelling go down. For sedentary patients and those who have vasculopathy or risks for poor healing, percutaneous surgical repair may be
Tendon transfer or positional transfers. Power transfers are done to perform motion, and therefore requires relatively more powerful donor muscles. Positional transfers, on the other hand, do not require powerful donors. The strength of the antagonist muscle should be similar to the donor to avoid overcorrection and to maintain correct posture. Tendon excursion, or distance a tendon travels upon movement, should be similar to that of the recipient to adequately restore the function. Any transfer of a tendon for another function will generally lose one grade of power. For example, M4 muscle power grade will become M3. A single tendon should be