Tenotomy is a medical procedure involving the precise cutting of a tendon, a strong band of connective tissue that links muscle to bone. This intervention aims to restore a more typical range of motion or to correct deformities caused by tight or imbalanced tendons. The procedure works by releasing the tension within the affected tendon, thereby allowing the associated joint or limb to move more freely.
Understanding Tenotomy
Tendons are fibrous tissues that transmit the force generated by muscles to bones, enabling movement. When a tendon becomes excessively tight, shortened, or contracted, it can restrict joint movement and lead to deformities or pain. This tightness can arise from various factors, including congenital conditions, neurological disorders, or injuries. Tenotomy lengthens the tendon, rebalancing forces on a joint. This allows for improved flexibility and often reduces discomfort.
Conditions Addressed by Tenotomy
Tenotomy is a treatment option for several medical conditions where tendon tightness or imbalance limits function. For clubfoot, an Achilles tenotomy lengthens the tight heel cord, allowing the foot to be positioned more normally. Children with spasticity from cerebral palsy undergo tenotomies to improve limb posture and reduce stiffness. It is also applied in strabismus, or “crossed eyes,” to correct eye alignment by adjusting specific eye muscle tendons. These interventions aim to alleviate contractures and facilitate better mobility or alignment in the affected areas.
The Tenotomy Procedure and Recovery
Tenotomy is performed using minimally invasive techniques. It involves local or general anesthesia. A small incision, often just a few millimeters, is made to access the tendon, which is then cut. A percutaneous approach, where the tendon is cut through the skin without an open incision, may also be used.
After the procedure, pain management begins, and the treated area is bandaged, casted, or splinted to protect the healing tendon and maintain the new position. Initial recovery involves a period of immobilization, lasting several weeks, to allow the tendon to heal in its lengthened state.
Expected Outcomes
The long-term goals of a tenotomy include improved function, increased range of motion, and better alignment of the affected limb or joint. Patients experience a reduction in pain and correction of deformities. Post-operative physical therapy or rehabilitation is a component of recovery, strengthening muscles and ensuring the tendon heals effectively in its new length. While safe, complications can include infection at the incision site or the tendon healing either too long (over-correction) or not long enough (under-correction), which may necessitate further intervention.