Name of the Procedure:

Tenodesis; of distal joint, each joint

• Common name: Tenodesis surgery
• Medical term: Distal joint tenodesis

Summary

Tenodesis is a surgical procedure that involves attaching a tendon to a bone to stabilize a distal joint. This helps to restore normal function and alleviate pain or instability in the joint.

Purpose

• Medical Condition: Addresses issues such as tendon injuries, chronic joint instability, and certain forms of arthritis that affect the distal joints (e.g., fingers or wrists).
• Goals: To stabilize the joint, reduce pain, improve joint function, and prevent further joint degeneration.

Indications

• Joint instability due to tendon injury or rupture
• Chronic pain from tendinopathy or arthritis
• Specific cases of rheumatoid or osteoarthritis affecting distal joints
• Failed conservative treatments, including physical therapy or medications

Preparation

• Pre-procedure Instructions: May need to fast for several hours before the procedure if general anesthesia is used. Adjustments to medications, especially blood thinners, may be necessary.
• Diagnostic Tests: Imaging studies like X-rays or MRIs to assess the condition of the joint and surrounding tissues. Preoperative blood tests may also be required.

Procedure Description

1. Anesthesia: Local, regional, or general anesthesia is administered depending on the patient's condition and the joint involved.
2. Incision and Exposure: A small incision is made near the affected joint to access the tendon and bone.
3. Tendon Fixation: The tendon is reattached to the bone using sutures, screws, or other fixation devices.
4. Closure: The incision is closed with sutures or staples and a sterile dressing is applied.
5. Immobilization: The joint may be immobilized in a splint or cast to ensure proper healing.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity and the number of joints involved.

Setting

Performed in a hospital operating room or an outpatient surgical center.

Personnel

• Surgeon: Orthopedic or hand surgeon
• Nurses: Assist with surgery and patient care
• Anesthesiologist: Administers anesthesia and monitors the patient

Risks and Complications

• Common Risks: Infection, bleeding, and pain at the surgical site
• Rare Complications: Nerve damage, tendon re-rupture, and poor wound healing
• Management: Antibiotics for infection, pain management strategies, and physical therapy for rehabilitation

Benefits

• Improved joint stability
• Reduction in pain
• Enhanced joint function
• Long-term relief and prevention of further joint damage
• Benefits typically realized within a few weeks to months post-surgery

Recovery

• Post-procedure Care: Keep the incision clean and dry, follow-up with the surgeon for wound checks and suture removal.
• Recovery Time: Several weeks to a few months, depending on the extent of surgery and patient’s adherence to rehabilitation.
• Restrictions: Limited use of the joint initially, gradual return to normal activities with physical therapy guidance

Alternatives

• Non-surgical Options: Physical therapy, corticosteroid injections, and use of splints or braces
• Surgical Alternatives: Different types of tendon repair or reconstruction surgeries
• Pros and Cons: Non-surgical options are less invasive but may not provide long-term relief. Surgical alternatives can also be effective but carry similar risks and recovery profiles.

Patient Experience

• During Procedure: Depending on the type of anesthesia, the patient may be awake (with local) or asleep (with general or regional anesthesia). They should expect minimal discomfort.
• After Procedure: Some pain and swelling around the surgical site, which can be managed with prescribed pain medications and ice. Instructions for at-home care and signs of complications to watch for will be provided.

By providing a comprehensive and clear overview of the Tenodesis procedure, patients can better understand what to expect and make informed decisions about their healthcare.