Tendon reconstruction surgery is a common procedure that aims to repair tendons that have been damaged or torn. Surgeons try to save as much existing tendon tissue as possible and, when necessary, graft pieces of new tissue from another less vital tendon into place. The most common sites for tendon reconstruction are the wrist, knee, ankle, and shoulder. Most operations can be performed in less than two hours in a hospital or surgical center, and the procedure has a high success rate. Patients generally need to get several weeks of rest and participate in months of physical therapy before they can return to normal activity levels.
There are a few different approaches to tendon reconstruction, and a surgeon can choose the best way to operate based on the location and severity of a tendon tear. In most cases of minor injuries, tendon reconstruction can be accomplished without making a large, open incision. Instead, a fiber optic tube called an arthroscope is used to visualize the damaged tendon and guide the surgery. Arthroscopes are equipped with specialized cameras that relay video in real-time to television monitors in the operating room. A skilled surgeon can use an arthroscope to repair both large and small tendons.
Before the procedure, a patient may be placed under general anesthesia or given an injection of localized anesthetic in the affected body part. A small incision is made near the site of the injury and the arthroscope is carefully inserted. The surgeon carefully inspects the area and plans the rest of the surgery. One or two more small cuts are made to accommodate surgical tools.
Suction devices and scalpels are used to clear away tissue that is damaged beyond repair. When there is sufficient healthy tendon tissue left over, the surgeon can secure it back together with sutures or pins. If a piece needs to be replaced, a non-vital tendon may be cut from another part of the body and grafted in place. Occasionally, an entire tendon may need to be replaced with a new biological tendon from a deceased donor.
Some major tendon ruptures cannot be reconstructed in an arthroscopic procedure. The surgeon instead makes a long incision along the length of the tendon and pins skin, muscle, fat, and cartilage aside. With the tendon exposed, he or she can make the necessary repairs. Open tendon reconstruction surgery is often easier to perform, though it usually takes longer for a patient to recover when compared to an arthroscopic procedure.
Following either type of surgery, a patient can expect to stay in the hospital for at least one night. He or she is given pain medications and fitted with a supportive brace, cast, or wrap to protect the healing tendon. After a period of rest, the patient can begin stretching and strengthening exercises with a physical therapist. Most people are able to regain most, if not all, of their strength and mobility after a few months.