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Tenolysis

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Tenolysis

(Tendolysis)

Definition

Tenolysis is surgery to release a tendon affected by adhesions. A tendon is a type of tissue that connects muscle to bone. An adhesion happens when scar tissue forms and binds tendons to surrounding tissue. This can make it difficult for the affected body part to work correctly. For example, adhesion in the fingers can cause the tendons to become stuck. This prevents the fingers from being able to move properly.
This surgery is often done on hands and wrists.
Tendons in Finger
Finger Tendon
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Reasons for Procedure

You may have tendon adhesions if you had an injury to the area or if you had surgery that affected the tendon. Tenolysis is done when other therapies, like physical therapy, are unsuccessful.
In addition to tenolysis, the doctor may need to do other procedures. The goal is to have full movement of the affected body part.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
  • Damage to nerves or other nearby structures
  • Inability to have full movement of the affected body part
  • Pain and stiffness
  • Infection
  • Amputation
Factors that may increase the risk of complications include:

What to Expect

Prior to Procedure

Your doctor may do the following:
  • Physical exam
  • Blood and urine tests
  • MRI to see images of the affected tendon
Talk to your doctor about any medications, herbs, or supplements you are taking. You may be asked to stop taking some medications up to one week before the procedure, like:
  • Aspirin or other anti-inflammatory drugs
  • Blood-thinning drugs, such as warfarin
  • Anti-platelet drugs, such as clopidogrel
Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.

Anesthesia

Anesthesia will keep you pain-free and comfortable during the procedure. Anesthesia methods include:

Description of the Procedure

A tourniquet will be tied near the area where the surgery will occur. This will prevent blood flow to that area. The doctor will make an incision in the skin to expose the tendon and surrounding tissue. The tissue will be cut to release the tendon. During surgery, the doctor will check your ability to move the affected body part. Based on your abilities, the doctor can assess if the procedure is working or if additional procedures need to be done. This may include reconstructing the tendon. The incision will be closed with stitches.

How Long Will It Take?

This depends on which tendon is affected and how bad the adhesions are. For example, if you injured the flexor tendon in your finger, it can take 45-60 minutes to repair.

How Much Will It Hurt?

Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.

Average Hospital Stay

This procedure is done in a hospital setting. The usual length of stay is 1-2 days. If you have any problems, you will need to stay longer.

Post-procedure Care

At the Hospital
Right after the procedure, you will be taken to recovery and monitored closely. The staff may give you:
  • Pain medication
  • Antibiotics to prevent infection
  • Medication to prevent blood clots
At Home
When you return home, do the following to help ensure a smooth recovery:
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Your stitches will be removed about 2 weeks after surgery. You will be able to return to light activities once your stitches are removed. Avoid strenuous activities for at least four weeks.
  • You will continue physical therapy once you are home. The physical therapist will work with you on exercises to help you regain motion and strength. This will start the day after surgery.
  • If you are wearing a splint, your doctor will let you know how long you should wear it.
  • Do not drive until your doctor tells you it is safe.
  • Be sure to follow your doctor’s instructions.

Call Your Doctor

Call your doctor if any of the following occurs:
  • Pain that you cannot control with the medications you have been given
  • Signs of infection, such as fever or chills
  • Swelling, redness, or pain from the incision site
  • Numbness or tingling
  • New or worsening symptoms
If you think you have an emergency, call for medical help right away.

RESOURCES

American Academy of Orthopaedic Surgeons http://orthoinfo.org

American Society for Surgery of the Hand http://assh.org

CANADIAN RESOURCES

The Canadian Orthopaedic Association http://coa-aco.org

Canadian Orthopaedic Foundation http://canorth.org

References

Feldscher SB, Schneider LH. Flexor tenolysis. Hand Surg. 2002;7(1):61-74.

Overview of hand surgery. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/plastic%5Fsurgery/overview%5Fof%5Fhand%5Fsurgery%5F85,P01130/. Accessed May 6, 2013.

Replantation. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00314. Updated May 2001. Accessed May 6, 2013.

6/6/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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