Tendon Repair Surgery: Common Procedures and Recovery Tips

Tendons are an integral part of our musculoskeletal system, connecting muscles to bones and enabling movement. However, when tendon injuries occur, they can severely impact our ability to perform daily activities. 

Whether you're curious about the surgical process or seeking tips to enhance your recovery, this article has got you covered. This comprehensive guide will explore the world of tendon repair surgery, shedding light on common procedures and providing essential recovery tips.

How do tendons get injured?

Tendon injuries occur when the tendons, which connect muscles to bones, become damaged or torn. These injuries can result from various causes, including overuse, trauma, acute injury, age-related degeneration, and sports accidents.

The types of tendon injuries can vary based on their severity and location. Here are some common examples:

• Tendinitis
• Tendinosis
• Tendon strain
• Tendon rupture
• Tenosynovitis

If you suspect a tendon injury or experience persistent pain or functional limitations, it's recommended to consult with a healthcare professional for a proper diagnosis and appropriate treatment plan.

The decision to undergo tendon surgery is individualized and depends on various factors, including the type and severity of the injury and the patient's overall health, lifestyle, and functional goals. 

Consulting with a healthcare professional specializing in orthopedics or sports medicine is crucial to determine the most appropriate treatment plan for each specific injury case.

What are the different types of tendon repair procedures?

Different types of tendon repair procedures may be performed depending on the specific tendon injury and its characteristics. Here are some common types of surgical procedures used to treat tendon muscle injuries:

1. Primary tendon reconstruction

Primary tendon repair is a surgical procedure performed to directly reattach the torn ends of a tendon using sutures. It is typically used for acute injuries where the muscle has undergone a clean, well-aligned tear. The procedure aims to restore the continuity of the connective tissue, allowing it to heal and regain its strength and function.

During primary tendon surgery, the surgeon carefully aligns the torn ends of the tendon and sutures them together using strong stitches. 

The sutures hold the ends of the filaments in place, facilitating the healing process. In some cases, additional techniques, such as reinforcement with suture anchors or augmentation with biological or synthetic materials, may be used to enhance the stability and strength of the repair.

2. Tendon grafting

Tendon grafting is a type of surgery used to fix a tendon with a gap or insufficient tissue for direct reconstruction. It involves using a graft一a piece of tendon tissue一to bridge the gap between the torn ends of the injured tendon.

• During tendon grafting, the surgeon harvests a tendon graft from another part of the patient's body (autograft) or uses a donor graft from a cadaver (allograft). The choice of graft depends on factors such as the location and size of the tendon injury, the patient's overall health, and the surgeon's preference.
• The harvested tendon graft is carefully prepared and trimmed to the appropriate size.
• It is then secured to the torn ends of the damaged tendon using sutures or specialized fixation devices. 
• The graft acts as a scaffold, facilitating the healing process and providing support for new tissue growth. 
• Over time, the body's natural healing processes integrate the graft with the surrounding tissues, effectively replacing the injured portion of the tendon.

Tendon grafting is commonly performed when there is a substantial gap between the torn tendon ends or when the quality of the muscle tissue is compromised. It allows for the reconstruction of the tendon and restoration of its strength and functionality.

3. Tendon transfer

Tendon transfer, or tendon reconstruction or transposition, is a surgical procedure that involves rerouting a functional tendon from its original muscle and attaching it to a different muscle or bone to restore or enhance the movement of a specific joint.

• During tendon transfer surgery, the surgeon carefully identifies and accesses the healthy tendon that will be transferred. 
• The tendon is detached from its original insertion site, preserving its blood supply and integrity. 
• The surgeon then repositions the tendon, often passing it through a pulley system or tunnel, and secures it to its new attachment site using sutures, anchors, or other fixation techniques.
• The transferred tendon assumes the role and function of the damaged or non-functional tendon, thereby restoring muscle strength, joint stability, or specific movement patterns.

This procedure is commonly used to address conditions such as tendon ruptures, severe tendon injuries, nerve palsies, and muscle imbalances. The purpose of tendon transfer is to compensate for the loss of function or strength caused by a damaged or non-functional tendon. 

4. Arthroscopic tendon repair

Arthroscopic tendon reconstruction is a minimally invasive surgical procedure used to diagnose and treat damaged or torn tendons using arthroscopy. Arthroscopy involves using a tiny camera called an arthroscope and specialized surgical instruments inserted through small incisions.

• During an arthroscopic tendon procedure, the surgeon makes small incisions near the affected joint and inserts the arthroscope to visualize the damaged tendon and surrounding structures. 
• The arthroscope transmits images to a monitor, allowing the surgeon to assess the extent of the tendon injury and guide the process.
• Using specialized instruments, the surgeon performs the reconstruction by reattaching the torn ends of the tendon. Sutures or other fixation techniques are used to secure the tendon in its proper position and promote healing. 
• In some cases, additional procedures such as debridement (removal of damaged tissue) or tissue augmentation may be performed during the arthroscopic procedure.

The advantages of arthroscopic tendon reconstruction include smaller incisions, reduced tissue trauma, decreased scarring, and potentially faster recovery compared to traditional open surgery. 

Additionally, it allows for better visualization of the joint structures, precise repair, and the ability to simultaneously address any associated joint pathology.

5. Open tendon surgery

Open tendon surgery, also known as traditional or open tendon repair, is a procedure that involves a larger incision made directly over the affected tendon to access and fix it. Unlike minimally invasive procedures, open tendon surgery involves a more extensive surgical approach.

• During open tendon surgery, the surgeon makes a single, longer incision or multiple incisions over the affected tendon area. This provides direct access to the injured tendon and allows for better visualization and manipulation of the tissues.
• Once the tendon is exposed, the surgeon carefully examines the extent of the injury and prepares the damaged tendon for restoration. 
• The torn ends of the tendon are aligned and sutured together using strong stitches or sutures. In some cases, additional techniques, such as reinforcement with suture anchors or augmentation of synthetic materials, may be performed.

Open tendon surgery is often performed in cases where the tendon injury is complex, extensive, or requires additional procedures beyond simple repair.

Frequently asked questions about tendon repair surgery?

How can I prepare myself for tendon repair surgery?

Preparing yourself for a tendon reconstruction procedure is vital to ensure a smooth and successful surgery. First, attend your scheduled appointment with your orthopedic surgeon, who will discuss the surgery in detail. 

Additionally, they will assess your overall health, review your medical history, perform any necessary tests or imaging, and provide specific instructions for preparation. Here are some other preparation tips that you may follow:

• Follow pre-operative instructions, such as specific medications to avoid, fasting guidelines, and other lifestyle modifications.
• Arrange for transportation on the day of surgery and to drive you home afterward. You may feel groggy or have limited mobility immediately after the procedure, so having assistance is essential.
• Inform your physician about the medications and supplements you are currently taking. 
• If you smoke, consider quitting or reducing smoking before surgery, as smoking can impair healing.
• Make necessary arrangements at home to ensure a comfortable and safe recovery. Prepare your living space, arrange for any required assistive devices (crutches or braces), and stock up on essential supplies.

How long does tendon repair surgery typically take?

The duration of tendon repair can vary depending on the location and complexity of the tendon injury, the specific surgical technique used, the surgeon's experience, and any additional procedures that may be performed. However, tendon reconstruction generally takes approximately 1 to 3 hours.

What to expect after the procedure?

After tendon surgery, it's important to have realistic expectations about the recovery process. Here are general aspects of what to expect and some recovery tips to boost healing:

• Your surgeon may immobilize the repaired tendon with a splint, cast, or brace immediately after surgery. 
• It's common to experience pain, swelling, and discomfort in the area of the surgical site. Your surgeon will prescribe pain medications to manage any post-operative pain.
• Elevating the affected limb and applying ice packs as directed can help reduce swelling and provide relief.
• You may be advised to restrict activities and avoid putting weight on the affected limb for a specific period. 
• Use crutches, braces, or other assistive devices as instructed. They aid in protecting the surgical site, maintaining stability, and facilitating safe movement during the early stages of recovery.
• Eat a balanced diet to support healing and tissue repair. Stay hydrated and avoid smoking or excessive alcohol consumption, which can impede recovery.
• You will have follow-up appointments with your surgeon to monitor your recovery progress. During these visits, the surgeon will assess the healing of the tendon, remove any stitches or sutures if necessary, and make any necessary adjustments to your rehabilitation plan.

What is the recovery time after tendon repair surgery?

It's important to note that recovery time is not solely determined by the surgical procedure itself but also by the rehabilitation process and your body's healing response. 

Generally, patients take at least 12 weeks to six months before they experience full healing and recovery. 

Will I need physical therapy after the surgery?

Rehabilitation plays a vital role in a patient’s recovery process. Your surgeon will prescribe a physical therapy program tailored to your specific needs. Physical therapy will focus on regaining the range of motion, strengthening the repaired tendon and surrounding muscles, and gradually returning to functional activities.

When can I return to normal activities and sports after tendon repair surgery?

The timeline for returning to normal activities will vary depending on the tendon repaired and your recovery progress. It's important to follow your surgeon's instructions regarding gradual return to activities to avoid re-injury. Returning to sports or high-impact activities will generally take longer and may require specific clearance from your surgeon.

Furthermore, active participation in post-operative physical therapy and adherence to the rehabilitation program is crucial for optimal recovery.

Where to find the best outpatient orthopedic clinic?

Are you in need of top-notch tendon reconstruction and exceptional orthopedic care? UNC Orthopedics Panther Creek is your premier destination for common and specialized orthopedic procedures.

Our clinic is staffed with highly experienced orthopedic surgeons who specialize in treating tendon injuries and other orthopedic conditions. We are equipped with state-of-the-art facilities and cutting-edge technology to ensure accurate diagnosis and precise surgical interventions, such as:

• Achilles tendon repair
• Carpal tunnel release
• Trigger finger release
• Hip arthroscopy
• Labral tear
• Hip replacement
• Knee arthroscopy
• Rotator cuff repair
• Lumbar microdiscectomy
• Cervical discectomy

And more!

Don't let tendon injuries or other orthopedic conditions hold you back. Contact us to learn more!

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.