Tendons are tough stretchy-like tissues that connect the muscle to the bone. Tendons enable the body to move; as the muscles contract, they (tendons) pull the bones causing movement in the joints. When there is damage to the tendon, movement can be seriously limited. Tendon repair is a surgery that is performed to treat a damaged or torn tendon in order to bring back movement to a joint. The procedure is performed during a limb reconstruction surgery.
Reasons for Tendon Repair Surgery
Tendon injury can occur anywhere in the body where tendons are present. But it mostly occurs in the shoulders, elbows, fingers, knees, and ankles.
Tendon damage can occur due to:
- An injury from contact sports
- A laceration that goes up to the tendon
- An injury or tear due to rheumatoid arthritis
Risk Factors of Tendon repair
Common risk factors associated with tendon repair include:
- Scar tissue
- Loss of motion due to joint stiffness
- Re-tearing of the tendon
There are some medical conditions which can limit the success of the tendon repair surgery and they include:
- Heart conditions
- Circulation problems
- Nerve conditions
- Alcohol and drug addiction
Diagnosing Tendon Injury
Diagnosis of a tendon injury involves the physician performing a physical exam on the injured area, which includes checking for:
- Blood loss
- Foreign objects if the injury is due to a laceration
- Other injuries such as fractures, nerve injuries, dislocations, or blood vessels injuries
- Range of motion on the injured side as compared to the uninjured side
Imaging tests such as MRI’s and Ultrasound can be done to help diagnose the precise location and cause of the tendon injury.
Tendon Repair Surgery Procedure
Before the tendon repair surgery, the surgeon will explain the procedure to the patient and provide anesthesia to make the patient comfortable and prevent pain during the surgery. The type of anesthetic that the doctor may use include:
- General anesthetic: This makes the patient unconscious during the procedure.
- Local anesthetic: Only numbs the area that needs surgery and the patient stays awake.
- Regional anesthetic: Numbs a large area of the body around the targeted area and the patient stays awake.
During the surgery, the surgeon will:
- Make an incision above the injured tendon through the skin
- Remove any damaged tendon tissue
- Sew together the torn ends of the tendon
- Check the surrounding area to make sure there are no other injuries
- Close the incision with medical stitches
- Cover the area with sterile dressings or bandages
- Splint or immobilize the joint so as to reduce tension while the tendon heals
Sometimes the tendon can be too short to be sewn back together. In such a case the surgeon grafts an extra piece of tendon between the injured tendon. This requires the surgeon to take a healthy tendon tissue from another part of the patient’s body, known as tendon transfer. The healthy tendon is usually taken from an area where there are two tendons, but the body can manage with just one such as the foot or toe.
Recovery from Tendon Repair Surgery
Tendon repair is usually done on an outpatient basis meaning the patient can go home after the procedure.
The recovery from the tendon repair surgery has three stages and they are:
- Inflammation: In the first 5 days, the area will be swollen as the body heals itself.
- Early repair: Range of motion starts to return in about 3-6 weeks, but the area will still feel stiff.
- Late repair: In 10-12 weeks the swelling will have gone down and it will be easier to move the tendon.
Post-Op Care After Tendon Repair Surgery
Occupational therapy or physical therapy exercises are recommended during the recovery period to help bring back the range in motion gradually and safely. However, the patient should wait for the surgeon’s approval before starting the exercises.
The area should be elevated to help decrease the swelling and manage the pain for the first few days.
In cases where there is too much scar tissue, surgery may be needed to minimize the scar tissue as it can make it difficult to move the injured area. Tendon repair surgery should be done as soon as the injury occurs as this makes the surgery and recovery easier.
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