Name of the Procedure:

Tenotomy, percutaneous, Achilles tendon (separate procedure); general anesthesia
Common Names: Achilles Tendon Release, Percutaneous Achilles Tenotomy

Summary

Achilles Tenotomy is a minimally invasive surgical procedure where a small incision is made to release or cut the Achilles tendon. This procedure is typically performed under general anesthesia.

Purpose

The procedure addresses conditions such as Achilles tendon contracture, chronic tendon issues, or deformities that limit ankle movement. The goal is to alleviate pain, improve mobility, and correct functional impairments.

Indications

• Chronic Achilles tendonitis
• Severe movement limitations due to tendon shortening
• Persistent pain that is not responsive to conservative treatments
• Conditions like clubfoot or cerebral palsy causing tendon tightness
• Patient age, activity level, and overall health may also influence the decision for surgery

Preparation

• Fasting for at least 6 hours before the procedure
• Stopping certain medications as advised by the doctor
• Preoperative imaging studies like X-rays or MRI to assess the tendon condition
• Discussing anesthesia options with an anesthesiologist

Procedure Description

1. The patient is placed under general anesthesia to ensure they are asleep and pain-free.
2. A small incision is made over the Achilles tendon at the back of the ankle.
3. Using specialized instruments, the surgeon carefully releases part of the tendon.
4. The incision is then closed with sutures, and a sterile dressing is applied.
5. The patient is monitored post-procedure to ensure stability.

Duration

The procedure usually takes about 20 to 30 minutes.

Setting

Achilles Tenotomy is typically performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic Surgeon or Podiatric Surgeon
• Anesthesiologist
• Surgical Nurses
• Operating Room Technician

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Incomplete tendon release
• DVT (Deep Vein Thrombosis)
• Recurrence of the original problem

Benefits

Patients can expect reduced pain and improved range of motion in the ankle. Full benefits may be noticed within a few weeks to months following the procedure.

Recovery

• Immobilization of the ankle with a cast or brace for about 4-6 weeks
• Gradual weight-bearing as advised by the surgeon
• Physical therapy to restore function and strength
• Follow-up appointments to monitor healing
• Instructions on pain management and wound care

Alternatives

• Conservative treatments like physical therapy, orthotics, and anti-inflammatory medications
• Consideration of corticosteroid injections
• Open surgical release for severe cases
• Each alternative comes with different benefits, risks, and effectiveness which should be discussed with the healthcare provider

Patient Experience

During the procedure, the patient will not feel anything due to general anesthesia. Post-procedure, the patient might experience some pain and swelling, which can be managed with prescribed pain medications. Comfort measures and limited activity will help aid recovery.