What is Tendon Repair

Tendon repair is surgery to fix a tendon that is torn (ruptured). The repair is done by reconnecting the torn ends of the tendon.

Tendons are like cords, and they connect muscles to bones. Tendons that commonly rupture and need surgical repair include those in the:

• Knee area (patellar tendon or quadriceps tendon).
• Elbow (triceps tendon).
• Shoulder (biceps tendon).
• Fingers (flexor tendons).
• Ankle (peroneal tendon or posterior tibial tendon).

You may need to wear a cast, splint, or brace for a few weeks after surgery while the injury heals.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to nearby structures, such as nerves, causing numbness.
• Stiffness or loss of function at the joint.
• Buildup of scar tissue.
• Re-rupture of the tendon.
• Blood clot.

What happens before the procedure?

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay tendon healing. If you need help quitting, ask your health care provider.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be asked to shower with a germ-killing soap.
• Ask your health care provider what steps will be taken to help prevent infection. These may include:
  • Removing hair at the surgery site.
  • Washing skin with a germ-killing soap.
  • Antibiotic medicine.

What happens during the procedure?

• An IV will be inserted into one of your veins.
• You will be given one of the following:
  • A medicine to numb the area (local anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• The surgeon will make a small incision in the skin over the damaged tendon.
• The surgeon will then repair the tendon using one of these methods:
  • If there is enough healthy tendon to work with, the surgeon will reconnect the torn ends of the tendon.
  • If there is not enough healthy tissue, the surgeon may use a piece of tendon from another part of your body to reconnect the torn tendon.
• If necessary, the surgeon will attach the tendon to the surrounding tissues.
• Your incision will be closed with stitches (sutures), skin glue, or adhesive strips. A bandage (dressing) will be applied to cover the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• You may have to wear a brace, splint, or cast to protect the healing tendon.
• You will be given pain medicine as needed.
• Ask your health care provider when it is safe to drive if you have a brace, splint, or cast on the injured area.
• Do not drive for 24 hours if you were given a sedative during your procedure.

Summary

• Tendon repair surgery is done to repair a tendon that is torn (ruptured).
• This surgery is often done to repair tendons in a knee, elbow, shoulder, finger, or ankle.
• During the procedure, the surgeon will reconnect the torn ends of the tendon.
• After the procedure, you may need to wear a cast, splint, or brace to protect the healing tendon.

Tendon Repair, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Soreness or pain.
• Stiffness.
• Limited range of motion in the joint where the tendon is repaired.

Follow these instructions at home:

If you have a splint or brace:

• Wear the splint or brace as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the splint or brace if your fingers or toes tingle, become numb, or turn cold and blue.
• Keep the splint or brace clean and dry.

If you have a cast:

• Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
• Check the skin around the cast every day. Tell your health care provider about any concerns.
• You may put lotion on dry skin around the edges of the cast. Do not put lotion on the skin underneath the cast.
• Keep the cast clean and dry.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
• If your splint, brace, or cast is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when you take a bath or a shower.
• Keep the bandage (dressing) dry until your health care provider says it can be removed.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or use heavy machinery while taking prescription pain medicine.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

• If directed, put ice on the affected area.
  • If you have a removable splint or brace, remove it as told by your health care provider.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag, or between your cast and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Move your fingers or toes often to avoid stiffness and to lessen swelling.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Activity

• Rest as told by your health care provider.
• Ask your health care provider what activities are safe for you during recovery, and ask what activities you need to avoid.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.
• Do not use the injured limb to support your body weight until your health care provider says that you can.
• If physical therapy was prescribed, do exercises as directed. Doing exercises may help to improve movement and flexibility (range of motion).

General instructions

• Do not put pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay tendon healing. If you need help quitting, ask your health care provider.
• Ask your health care provider when it is safe to drive if you have a splint, brace, sling, or cast on your arm or leg.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have redness, swelling, or pain at your incision site.
• You have fluid or blood coming from your incision site.
• Your incision feels warm to the touch.
• You have pus coming from your incision site.
• You have a bad smell coming from:
  • The incision site or dressing.
  • Underneath your cast or splint.
• You have a fever.
• Your stiffness or movement is not improving.

Get help right away if:

• You have trouble breathing.
• You have chest pain.
• Your heart beats more quickly than normal, or you feel it skipping beats.
• You have severe pain.

Summary

• After the procedure, it is common to have pain, stiffness, and limited range of motion.
• If your splint, brace, or cast is not waterproof, do not let it get wet.
• Contact your health care provider if you have blood, fluid, or pus coming from your incision site.