Tendon repair is surgery done to treat a torn or otherwise damaged tendon. Tendons are the soft, band-like tissues that connect muscles to bone. When the muscles contract, the tendons pull the bones and cause them to move.
When tendon damage occurs, movement may be seriously limited in the area of the damage. The damaged area may feel numb, weak, or painful.
Tendon repair surgery may be useful for patients who have tendon injuries that are making it difficult for them to move, or are very painful.
Tendon repair is done to bring back normal movement after a tendon injury. Tendon injury may occur anywhere in the body where there are tendons. According to Cooper University Hospital (CUH), the most common joints affected by tendon injuries are the shoulders, elbows, ankles, and knees (CUH).
Tendon injury may occur from a laceration (cut) that goes past the skin. Tendon injury is also common from contact sports injuries such as football, wrestling, and rugby.
According to the American Academy of Orthopedic Surgeons, “jersey finger" is one of the most common sports injuries affecting the tendons. It may occur when one player grabs the jersey of another player and gets their finger caught on the jersey. When the other player moves, the finger is pulled and the tendon is pulled off the bone (AAOS, 2011).
Tendon damage can occur in rheumatoid arthritis, an inflammation of the joints often caused by aging. Rheumatoid arthritis weakens the tendons, making them more susceptible to tearing. The tearing might not be noticeable at first.
Generally, during tendon repair a surgeon will:
- make one or more small incisions (cuts) in the skin over the damaged tendon
- sew the torn ends of the tendon together
- check the surrounding tissue to make sure no other injuries have occurred, such as injury to the blood vessels or nerves
- close the incision, often with stitches
- cover the area with sterile bandages or dressings
If there is not enough healthy tendon to reconnect, the surgeon may perform a tendon graft. This is when a piece of tendon from another part of the body is used. It may be from the foot, toe, or other body part. Sometimes the tendon must be reconnected to the surrounding tissue.
Anesthesia (pain medication) is used during tendon repair to prevent the patient from feeling pain during the surgery.
The types of anesthesia are:
- local anesthesia: the area where the surgery is to be performed is numbed and pain-free
- regional anesthesia: the surrounding area and the area where the surgery is to be performed is numbed and pain-free
- general anesthesia: the patient is unconscious (asleep) and unable to feel pain
Risks associated with tendon repair include:
- scar tissue, which may form and prevent the joints from moving smoothly
- some loss of joint use
- stiffness of the joint
Risks for anesthesia include reaction to medication and difficulty breathing. Risks for surgery in general include bleeding and infection.
Tendon repairs are usually done on an outpatient basis. This means the patient can go home after the surgery. If the patient does stay in the hospital, it is usually for a short period of time.
Healing can take up to 12 weeks. The injured tendon may need to be supported with a splint or cast in the meantime.
Physical therapy may be necessary to return movement in a safe manner. Expect movement to return gradually, with some stiffness.
You may need treatment after the surgery to minimize scar tissue. Too much scar tissue can make it difficult to move the damaged tendon.
According to the National Institutes of Health, most tendon repairs are successful if done with proper physical therapy. Not too long after surgery, the patient will likely be able to use the affected joint without pain (NIH, 2010).
According to the AAOS, the sooner tendon repair surgery is done, the easier the recovery will be. Surgery is generally done seven to 10 days after the injury (AAOS, 2011).
In some cases, long-term complications may develop. Stiffness may be long lasting. Some tendon injuries, such as injuries to the flexor tendon in the arm, can be very difficult to repair. Before surgery, discuss potential outcomes with your doctor so that you have a realistic view of your individual outlook.