Tendon repair

Repair of tendon

Definition

Tendon repair is surgery to repair damaged or torn tendons.

Description

Tendon repairs can often be done in an outpatient setting. Hospital stays, if any, are short.

Tendon repair can be performed using:

  • Local anesthesia (immediate area of the surgery is pain-free)
  • Regional anesthesia (local and surrounding areas are pain-free)
  • General anesthesia (asleep and pain-free)

The surgeon makes a cut on the skin over the injured tendon. The damaged or torn ends of the tendon are sewn together.

If the tendon has been severely injured, a tendon graft may be needed.

  • In this case, a piece of tendon from another part of the body or an artificial tendon is used.
  • If needed, tendons are reattached to the surrounding tissue.
  • The surgeon examines the area to see if there are any injuries to nerves and blood vessels.
  • When the repair is complete, the wound is closed and bandaged.

If the tendon damage is too severe, the repair and reconstruction may have to be done at different times. The surgeon will perform one surgery to repair part of the injury. Another surgery will be done at a later time to finish repairing or reconstructing the tendon.

Why the Procedure Is Performed

The goal of tendon repair is to bring back normal function of joints or surrounding tissues following a tendon injury or tear.

Risks

Risks of anesthesia and surgery in general include:

  • Breathing problems
  • Reactions to medicines
  • Bleeding, blood clots, infection

Risks of this procedure include:

  • Scar tissue that prevents smooth movements
  • Pain that does not go away
  • Partial loss of function in the involved joint
  • Stiffness of the joint
  • The tendon tears again

Before the Procedure

Tell your surgeon what medicines you are taking. These include medicines, herbs, and supplements you bought without a prescription.

During the days before the surgery:

  • Prepare your home for when you leave the hospital.
  • If you are a smoker or use tobacco, you need to stop. You may not heal as well if you smoke or use tobacco. Ask a health care provider for help quitting.
  • Follow instructions on stopping blood thinners. These include warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), or NSAIDs such as aspirin. These might cause increased bleeding during surgery.
  • Talk with your surgeon if you have been drinking a lot of alcohol, more than 1 to 2 drinks per day.
  • Ask your surgeon which medicines you should still take on the day of the surgery.
  • Let your surgeon know about any cold, flu, fever, herpes breakout, or other illnesses you may have. 

On the day of the surgery:

  • Follow instructions about not drinking or eating anything before the procedure.
  • Take the medicines you were told to take with a small sip of water.
  • Arrive at the hospital on time.

After the Procedure

Healing may take 6 to 12 weeks. During that time:

  • The injured part may need to be kept in a splint or cast. Later, a brace that allows movement may be used.
  • You'll be taught exercises to help the tendon heal and limit scar tissue.
  • It is important to give the tendon time to recover. Closely following the instructions from your healthcare provider will help ensure a positive outcome.

Outlook (Prognosis)

Most tendon repairs are successful with proper and continued physical therapy.

References

Cannon DL. Flexor and extensor tendon injuries. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 66.

Irwin TA. Tendon injuries of the foot and ankle. In: Miller MD, Thompson SR, eds. DeLee, Drez & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 118.

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Review Date: 9/20/2022

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.


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