Brief Answer: Reconstruction not essential but possible Detailed Answer: Hello XXXX, This is a very unfortunate problem to have affected you. I would like to answer your last question 1st. You do not have to have further surgery on yor Achilles' tendon. you will struggle to walk however without an ankle foot orthosis (AFO). This is a plastic splint which goes from the end of your toes up the back of your calf and would enable you to push off in the front of your foot as you walk. If you did decide on further surgery it is important that your surgeon would be confident that your infection has been fully treated. It's unlikely after such a period of time and with a significant remaining gap in the tendon that the surgery could get the tendon ends together and so you would be looking at a tendon graft - either from sacrificing one of your own not so important tendons or using a cadavaric tendon to reconstruct your Achilles tendon. you may also require plastic surgery to ensure a viable wound closure following the reconstruction as the tissues in that area would likely be of poor quality from the previous surgery and infection. the reconstructed tendon would likely not act as a normal tendon but would be more of a tenodesis where it would fix your heel without too much excursion (movement) so that you had something to push against when you toe off in gait. You would likely have some degree of ongoing permanent limp. Your are in a difficult spot. what I might do if I were you is to try an AFO 1st and see how you manage with this. Best wishes

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