Name of the Procedure:

Tenotomy, Percutaneous, Adductor or Hamstring; Single Tendon (Separate Procedure)

• Common Name: Percutaneous Tenotomy
• Technical Terms: Minimally Invasive Tendon Release

Summary

In a percutaneous tenotomy, a surgeon makes a small incision to release a tight or contracted tendon. This procedure helps to relieve pain and improve mobility by cutting and lengthening the tendon fibers. It is commonly used for the adductor or hamstring tendons.

Purpose

The primary goal of this procedure is to improve the range of motion and decrease pain caused by tight or contracted tendons in the adductor or hamstring muscles. Conditions such as muscle contractures, spasticity due to neurological disorders, or chronic tendonitis often necessitate this procedure.

Indications

• Patients experiencing chronic pain or mobility issues in the lower limbs due to tight adductor or hamstring muscles.
• Muscle contractures resulting from conditions like cerebral palsy or after certain injuries.
• Persistent tendon tightness unresponsive to conservative treatments such as physical therapy or medications.

Preparation

• Patients may need to fast for a few hours prior to the procedure.
• Medications that thin the blood may need to be adjusted or stopped in advance.
• Diagnostic tests such as MRI or ultrasound may be performed to evaluate the extent of tendon tightness and to plan the procedure.

Procedure Description

1. The patient is positioned to provide optimal access to the affected tendon.
2. Local anesthesia is administered to numb the area; sedation may be used for patient comfort.
3. A small incision is made near the tendon.
4. Specialized instruments are used to cut the tendon fibers, carefully releasing tension.
5. Minimal suturing or adhesive strips may be used to close the incisions.
6. The incision area is covered with a sterile bandage.

Duration

The procedure typically takes about 30-60 minutes.

Setting

Percutaneous tenotomy is usually performed in an outpatient surgical center or hospital.

Personnel

• The main healthcare professionals involved include an orthopedic or general surgeon, an anesthesiologist, and nursing staff.

Risks and Complications

• Common risks include infection, bleeding, and bruising at the incision site.
• Possible complications may involve incomplete tendon release, nerve injury, or recurrence of tendon tightness.
• Most complications are manageable with appropriate medical care.

Benefits

• Improved range of motion and decreased pain in the affected limb.
• A minimally invasive approach means a quicker recovery and less postoperative discomfort compared to open surgery.
• Benefits are typically realized in a few weeks to a couple of months post-procedure.

Recovery

• Post-procedure care includes keeping the incision clean and dry.
• Physical therapy may be recommended to enhance recovery and improve mobility.
• Most patients can resume normal activities within a few weeks, but strenuous activities may need to be limited for a few months.

Alternatives

• Conservative treatments: physical therapy, stretching exercises, and medications.
• Open surgical tendon release: more invasive with longer recovery time.
• Orthotic devices: may provide relief but not resolve the underlying problem.

Patient Experience

• During the procedure, patients will feel minimal discomfort due to local anesthesia.
• Post-procedure pain is generally mild and can be managed with over-the-counter pain relievers.
• Patients are advised to rest and avoid strenuous activities and to follow the physical therapy regimen prescribed to ensure optimal recovery.