Tendon transplantation

When a tendon transplant is carried out, the injured tendon is removed and replaced with a healthy one. A healthy, superfluous tendon is removed from another part of the body. Tendon transplant surgery is a tried-and-tested treatment procedure for injuries of the hand tendons.

If the tendon cannot be sutured back together, tendon transplant surgery is used. The ends of the torn tendons may be too far apart from each other, or the tendon may have shortened as a result of tightening up. Tendon transplant surgery is used particularly often to treat patients with injuries to the flexor tendon in the hand, resp. the finger.

What preparations are carried out before the procedure?

Before the operation, the injured hand is thoroughly examined and x-ray images or MRI images are prepared.

Antihaemorrhagic agents are discontinued a few days beforehand. As is customary before operations, blood tests, an ECG and blood pressure measurements are also undertaken. Patients should have an empty stomach for the procedure.

How is the operation carried out?

Tendon transplant surgery can often be carried out on an outpatient basis with regional anaesthesia (plexus anaesthesia). In the process, the hand surgeon exposes the injured tendon and replaces or reconstructs it with the help of a piece of healthy tendon. A sleeve is fixed on the upper arm to keep the hand exsanguinous. Two operations are often required to transplant a tendon. In the first operation, the injured tendon is firstly removed and replaced with a silicon rod. The body then forms a tissue envelope around the silicon rod which serves as a slide bearing for the transplanted tendon. After a few weeks, this silicon rod is removed in a second operation and replaced with a transplanted tendon. A healthy, superfluous tendon is taken from another part of the body for the transplant. Depending on the requirements, the index finger, little finger, underarm or the thigh. The operation usually takes one to two hours.

What is the success rate of this procedure?

The goal of the operation is to re-establish the stability, movement and slippage capacity of the tendons. This can generally be well achieved with tendon transplant surgery.

What are the possible complications and risks of this procedure?

Tendon transplant surgery on the hand is a more complex procedure which must be carried out by specially trained hand surgeons. As with all surgery, the operation may occasionally lead to infections, nerve damage, post-operative haemorrhaging or blood clots. Sometimes transplanted tendon may tear or growths may occur, which makes further surgery necessary.

What happens after the operation?

The transplanted tendon requires some time until it has grown in correctly and can be used fully again. The injured tendon must be rested in a splint for three to six weeks. Special exercises encourage the healing process and support the movement and slippage capacity of the transplanted tendon. 

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