Tendon Repair and Reconstruction Surgery

Restoring Strength and Function to the Foot and Ankle

Tendons are the vital tissues that connect muscles to bones, enabling movement and providing stability. When a tendon in the foot or ankle is severely damaged, torn, or has degenerated over time, surgical intervention may be necessary to restore its function. Tendon repair and reconstruction are advanced surgical procedures designed to fix the damaged tendon, re-establish a strong muscle-to-bone connection, and improve overall strength and mobility.

At City Orthopaedics & Sports Medicine, our foot and ankle surgeons, including Foot and Ankle Surgeon Dr. Jason Hymowitz specialize in these complex procedures, utilizing state-of-the-art techniques to treat everything from acute ruptures to chronic degenerative conditions.

When is Tendon Surgery Necessary?

While most tendon problems can be managed with non-surgical care, surgery is often the best option in the following situations:

• Acute Tendon Rupture: A complete tear of a major tendon, such as the Achilles tendon, often requires direct surgical repair to ensure proper healing and strength.
• Chronic Tendinosis: When a tendon has become severely degenerated and thickened from long-term overuse, causing persistent pain and dysfunction that has not responded to conservative treatments.
• Significant Partial Tears: Large partial tears that cause weakness and pain and fail to heal on their own may need to be surgically repaired.
• Tendon Dysfunction with Deformity: A prime example is advanced Posterior Tibial Tendon Dysfunction (PTTD), where the collapsed tendon leads to a progressive flatfoot deformity.

Common Tendon Procedures for the Foot and Ankle

The specific surgical technique used depends on the tendon involved and the extent of the damage. Our surgeons are skilled in a range of procedures:

• Tendon Repair (Tenorrhaphy): For an acute rupture, the surgeon will carefully stitch the torn ends of the tendon back together, restoring its length and tension.
• Tendon Debridement: In cases of chronic tendinosis, the surgeon will remove the inflamed, damaged, and degenerative tissue from the tendon. This encourages a healing response and reduces pain.
• Tendon Transfer: If a tendon is too damaged to be repaired, our surgeon may perform a tendon transfer. This involves rerouting a nearby, healthy tendon to take over the function of the damaged one. This is a common and effective procedure for treating advanced PTTD and restoring arch support.
• Tendon Grafts: In some cases, a piece of tendon from a donor (allograft) or from another part of your body (autograft) may be needed to bridge a gap or reinforce a repair.

What to Expect During Recovery

Recovering from tendon surgery is a gradual process that requires a significant commitment to the rehabilitation protocol to achieve the best outcome.

• Immobilization: A period of strict immobilization in a cast or walking boot is essential to protect the delicate tendon repair. This may last for several weeks.
• Non-Weight-Bearing: You will likely need to use crutches and keep all weight off the foot for a period of time to allow the tendon to heal without stress.
• Physical Therapy: This is a critical component of your recovery. Once your surgeon gives the go-ahead, you will begin a carefully structured physical therapy program to gradually restore your range of motion, flexibility, and strength.
• Return to Activity: The timeline for recovery is often lengthy. While you may be back to daily walking in a few months, a full return to sports and high-impact activities can take anywhere from six months to a year.