Tendon repair
Tendon repair refers to the surgical and therapeutic procedures aimed at restoring the function of tendons, which are fibrous connective tissues that attach muscles to bones. Tendons, such as the Achilles tendon in the foot and those in the hand, can be injured due to cuts, ruptures, or inflammation caused by physical activities. Common symptoms of a ruptured tendon include sudden pain and an inability to perform specific movements, particularly evident in the Achilles tendon where standing on tiptoe is affected.
Treatment for tendon injuries may start with conservative approaches like rest and corticosteroid injections for inflammation. However, severe cases often necessitate surgical intervention to suture the torn tendon ends together. Tendon healing can be complicated due to the poor blood supply to these tissues, which can hinder recovery. Emerging therapies such as platelet-rich plasma therapy and stem cell therapy are being explored to enhance the healing process. These methods aim to deliver growth factors and stimulate tissue regeneration, potentially improving surgical outcomes and recovery times. Overall, tendon repair is a critical area of orthopedic medicine with significant implications for restoring mobility and function.
Tendon repair
Anatomy or system affected: Bones, feet, hands, joints, knees, legs, ligaments, muscles, musculoskeletal system, tendons
Definition: The surgical repair of tendons, the bands of tissue that attach muscle to bone.
Indications and Procedures
Tendons are straps of collagenous tissue that attach muscles to bone. They are strong and flexible; a tendon approximately 1.3 centimeters (0.5 inch) thick can support a ton. Tendons are most prominently observed in the hand, where they are associated with the muscles that move the fingers and thumbs, and in the heel, where the Achilles tendon joins the muscles and bones of the foot. The Achilles tendon is the longest and thickest tendon in the body.
Tendon injuries can be of several types. If the hand or foot is badly cut, the slice may enter or sever the tendon, resulting in an inability to move the fingers or toes. Tendons have also ruptured during physical activity; the Achilles tendon is at particular risk during certain running or jumping exercises. The sensation that the patient experiences with the initial tear has been likened to a kick. Severance of the Achilles tendon is indicated by an inability to stand on tiptoe.
More often, the Achilles tendon may become inflamed by activity. Such inflammation is usually indicated by pain that develops at the beginning and end of a run, but that seems to improve during the exercise. Often, the pain becomes worse at night. Treatment of minor inflammation generally involves rest or cessation of the activity. Corticosteroids may be administered to relieve the inflammation.
If a tendon has been cut or severed, surgery is often required for proper repair. Since tendons are under great tension, they may snap or regress from the site of the injury. The surgeon makes an incision through the affected area, whether hand or foot, and sutures the ends of the tendon together.
Uses and Complications
If carried out properly and quickly, tendon repair is generally satisfactory. The patient may be immobilized for weeks, and some permanent stiffness is common. Because the blood supply to tendons is poor, healing may be problematic. One modern method for repairing tendons is platelet-rich plasma therapy. Platelets produce growth factors, proteins that take part in the healing process. Blood is drawn from the patient being treated. The blood is spun down using a centrifuge to separate the plasma, which contains platelets, from the red and white blood cells. The resulting platelet-rich plasma is injected into the site of tendon damage, supplying the tendon with healing growth factors. These healing growth factors had been lacking because of the poor blood supply. Stem cell therapy is another twenty-first century method for aiding in the reconstruction of tendons and has allowed for surgeries that may have previously been impossible. Stem cells stimulate the growth of new tissue in the tendon, increasing the chances of a positive outcome.
Bibliography
Garrick, James G., and David R. Webb. Sports Injuries: Diagnosis and Management. 2d ed. Philadelphia: W. B. Saunders, 1999.
Irvin, Richard, Duane Iversen, and Steven Roy. Sports Medicine: Prevention, Evaluation, Management, and Rehabilitation of Athletic Injuries. 2d ed. Boston: Allyn & Bacon, 1998.
"Patellar Tendon Tear." American Academy of Orthopaedic Surgeons, August 2009.
"Quadriceps Tendon Tear." American Academy of Orthopaedic Surgeons, August 2009.
Scuderi, Giles R., and Peter D. McCann, eds. Sports Medicine: A Comprehensive Approach. 2d ed. Philadelphia: Mosby/Elsevier, 2005.
Sheyn, Dmitriy. “Developing New Ways to Repair Tendons.” Cedars-Sinai, 27 Apr. 2023, www.cedars-sinai.org/newsroom/developing-new-ways-to-repair-tendons. Accessed 21 July 2023.
Small, Eric, et al. Kids and Sports: Everything You and Your Child Need to Know About Sports, Physical Activity, and Good Health. New York: Newmarket Press, 2002.
"Tendon repair." MedlinePlus, August 11, 2012.
Weintraub, William. Tendon and Ligament Healing: A New Approach to Sports and Overuse Injury. Rev. ed. Brookline, Mass.: Paradigm, 2003.