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admin | Hips And Lower Back Pain | 17.01.2015
Tendon repair refers to the surgical repair of damaged or torn tendons, which are cord-like structures made of strong fibrous connective tissue that connect muscles to bones.
The goal of tendon repair is to restore the normal function of joints or their surrounding tissues following a tendon laceration. Women in all age brackets are at greater risk than men for injuries to the tendons in the elbow and knee joints. Local, regional or general anesthesia is administered to the patient depending on the extent and location of tendon damage. After the overlying skin has been cleansed with an antiseptic solution and covered with a sterile drape, the surgeon makes an incision over the injured tendon.
Diagnosis of a tendon injury is usually made when the patient consults a doctor about pain in the injured area. To prepare for surgery, the patient typically reports to a preoperative nursing unit, where he or she changes into a hospital gown.
Tendon repair surgery includes the risks associated with any procedure requiring anesthesia, such as reactions to medications and breathing difficulties.
Mortality rates for tendon repairs are very low, partly because some of these procedures can be performed with local or regional anesthesia, and partly because most patients with tendon injuries are young or middle-aged adults in good general health. There are no alternatives to surgery for tendon repair as of 2003; however, research is providing encouraging findings. The shoulder, elbow, knee, and ankle joints are the most commonly affected by tendon injuries. They are more common among people whose occupations or recreational athletic activities require repetitive motion of the shoulder, knee, elbow, or ankle joints. It is thought that injuries in these areas are related to the slightly greater looseness of women's joints compared to those in men.
When the tendon has been located and identified, the surgeon sutures the damaged or torn ends of the tendon together. The doctor will usually order radiographs and other imaging studies of the affected joint as well as taking a history and performing an external physical examination in the office.
A few days before the operation, patients are also instructed to stop taking such over-thecounter pain medications as aspirin or ibuprofen.


Next, the patient is taken to a preoperative holding area, where an anesthesiologist administers an intravenous sedative. Healing may take as long as 6 weeks, during which the injured part may be immobilized in a splint or cast. There are a variety of exercises, wraps, splints, braces, bandages, ice packs, massages, and other treatments that physical therapists may recommend or use in helping a patient recover from tendon surgery.
Conservative treatment has little if any chance of restoring optimal range of motion in the injured area. Morbidity varies according to the specific tendon involved; ruptures of the Achilles tendon or shoulder tendons are more difficult to repair than injuries to smaller tendons elsewhere in the body.
Although there is no presently approved drug that targets this notoriously slow and often incomplete healing process, a cellular substance recently discovered at the Lawrence Berkeley National Laboratory may lead to a new drug that would improve the speed and durability of healing for injuries to tendons and ligaments.
Injuries to the tendons in the shoulder often occur among baseball players, window washers, violinists, dancers, carpenters, and some assembly line workers. With a regional anesthetic, a specific region of nerves is anesthetized; with a local anesthetic, the patient remains alert during the surgery, and only the incision location is anesthetized. In some cases fluid will be aspirated (withdrawn through a needle) from the joint to check for signs of infection, bleeding, or arthritis. If patients have a cast, they are asked not to get it wet, to cover it with plastic while bathing, and to avoid exposing the cast to water. Patients who have been given antibiotics should take the complete course even if they feel well; this precaution is needed to minimize the risk of drug resistance developing in the disease organism. In addition, some postoperative complications result from patient noncompliance; in one study, two out of 50 patients in the study sample had new injuries within three weeks after surgery because they did not follow the surgeon's recommendations. The substance, called Cell Density Signal-1, or CDS-1, by its discoverer, cell biologist Richard Schwarz, acts as part of a chemical switch that turns on procollagen production. It involves the injection of dextrose or natural glycerin at the exact site of an injury to stimulate the immune system to repair the area.
Oblique pulley is more important than the A1 pulley; however both may be incised if necessary. This is a procedure in which a piece of tendon is taken from the foot or other part of the body and used to repair the damaged tendon.


If patients are taking medicine that makes them feel drowsy, they are advised against driving or using heavy equipment. Thus, prolotherapy causes an inflammatory reaction at the exact site of injuries to such structures as ligaments, tendons, menisci, muscles, growth plates, joint capsules, and cartilage to stimulate these structures to heal.
Orthopedics is the medical specialty that focuses on the diagnosis, care and treatment of patients with disorders of the bones, joints, muscles, ligaments, tendons, nerves and skin. The repetitive stresses of classical ballet, running, and jogging may damage the Achilles tendon at the back of the heel.
Scar tissue tends to form between the moving surfaces within joints, resulting in adhesions that hamper motion. It is transformed outside the cell into collagen, the basic component of such connective tissues as tendons, ligaments or bones. So-called tennis elbow, which occurs in many construction workers, highway crews, maintenance workers, and baggage handlers as well as professional golfers and tennis players, is thought to affect 5% of American adults over the age of 30. The surgeon inspects the area for injuries to nerves and blood vessels, and closes the incision. If patients have a splint that is held in place with an Ace bandage, they are instructed to ensure that the bandage is not too tight. To reduce swelling and pain, they should keep the injured limb lifted above the level of the heart as much as possible for the first few days after surgery. Revision surgery may be required to remove scar tissue, insert tendon grafts or other reconstructive procedures. The rapid production of new fibroblasts means that strong, fresh collagen tissue is formed, which is what is needed to repair injuries to ligaments or tendons. The location of the injury is also an important factor in determining how well a patient will recover after surgery.



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