Our Summary

Surgery to reattach tendons to bone, such as with rotator cuff repairs in older adults, often fails due to the different physical properties of tendon and bone. This leads to stress in the area which causes the repair to fail. Some recent research has found potential adhesives that can help reduce this stress and delay the failure. However, there hasn’t been much research into how to prevent the failure from progressing once it starts. In this research, they considered the process of failure when looking at the properties of adhesive materials. They found that the failure happens due to too much movement between the tendon and bone when strong and flexible adhesives are used, while with stiffer adhesives, the failure happens because the entire repair breaks apart if the adhesive isn’t strong enough. This led them to identify a small group of materials, including certain rubber-like substances and porous solids, that are suitable for use as adhesives when reattaching tendons to bone.

FAQs

  1. Why does surgery to reattach tendons to bone often fail in older adults?
  2. What are some potential solutions to prevent the failure of tendon repair surgeries?
  3. What types of materials have been identified as suitable for use as adhesives when reattaching tendons to bone?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tendon repair is to follow a post-operative rehabilitation program as prescribed by their healthcare provider. This program may include specific exercises to help strengthen the repaired tendon, improve range of motion, and prevent stiffness. It is important for patients to adhere to this program to optimize their recovery and reduce the risk of re-injury. Additionally, patients should avoid activities that put excessive strain on the repaired tendon until it is fully healed to prevent further damage.

Suitable For

Patients who have suffered tendon injuries, such as a torn rotator cuff, Achilles tendon rupture, or torn ligaments in the hand or wrist, may be recommended tendon repair surgery. These injuries are common in athletes, older adults, and individuals who engage in repetitive movements or activities that put stress on the tendons. Additionally, patients with chronic tendon conditions, such as tendinosis or tendinopathy, may also benefit from tendon repair surgery to alleviate pain and improve function. Ultimately, the decision to undergo tendon repair surgery will depend on the severity of the injury, the patient’s overall health, and their goals for recovery.

Timeline

Before tendon repair surgery:

  • Patient experiences pain, weakness, and limited range of motion in the affected joint
  • Patient may undergo imaging tests such as MRI to confirm the extent of the tendon injury
  • Patient may undergo physical therapy to strengthen the muscles surrounding the affected tendon

After tendon repair surgery:

  • Patient may experience pain and discomfort at the surgical site
  • Patient is typically placed in a sling or brace to immobilize the repaired tendon
  • Patient begins physical therapy to regain strength and range of motion in the affected joint
  • Patient may need to avoid certain activities or movements to prevent re-injury
  • Over time, the repaired tendon gradually heals and the patient regains function in the affected joint.

What to Ask Your Doctor

Some questions a patient should ask their doctor about tendon repair include:

  1. What type of tendon injury do I have and what are the treatment options available?
  2. What are the potential risks and complications associated with tendon repair surgery?
  3. How long is the recovery process and what physical therapy or rehabilitation will be necessary?
  4. What are the success rates of tendon repair surgery for my specific injury?
  5. Are there any alternative treatments or non-surgical options that I should consider?
  6. What type of adhesive material will be used during the tendon repair surgery and how does it help prevent failure?
  7. How can I prevent re-injury or further damage to the repaired tendon after surgery?
  8. What are the long-term outcomes and expectations for function and mobility after tendon repair surgery?
  9. Are there any lifestyle changes or modifications I should make to support the healing process and prevent future injuries?
  10. What follow-up appointments and monitoring will be necessary after the tendon repair surgery?

Reference

Authors: Avgoulas EI, Sutcliffe MPF, Linderman SW, Birman V, Thomopoulos S, Genin GM. Journal: J R Soc Interface. 2019 Apr 26;16(153):20180838. doi: 10.1098/rsif.2018.0838. PMID: 30966948