Tendon Transfer Surgery

Tendon transfer surgery is an orthopedic surgery where the affected tendon is shifted from its original place of attachment to a new one.

Your doctor may transfer a healthy tendon to replace a damaged one to restore function to normal movement.

When used on the right patient, tendon transfer surgery has positive results. 

Candidates for a Tendon Transfer Surgery

Your doctor may recommend tendon transfer surgery in the following cases:

• Nerve injuries. If you have a nerve injury that cannot be repaired, it will not send signals to make certain muscles work. Tendon transfer surgery can make those muscles function again.
• Muscle injuries caused by tendon ruptures due to rheumatoid arthritis or fractures, as well as irreparable tendon and muscle tears.
• Nervous system disorders such as cerebral palsy, traumatic brain injuries, stroke, or spine muscle atrophy.
• Congenital disabilities such as hypoplastic thumbs or birth brachial plexopathy where a baby was born without certain muscle functions. 

Risks Associated with Tendon Transfer Surgery

Risks associated with tendon transfer include:

• Bleeding.
• Infection or injury to nearby nerves, tendons, or blood vessels.
• Stiffness or weakness to transferred muscle.
• Tendon rupture.

In some cases, the tendon transfer does not heal correctly. The implant could break, or the underlying neurologic condition could progress, requiring more surgery.

Preparing for a Tendon Transfer Surgery

In preparation for a tendon transfer surgery, your doctor will review instructions for you to follow before your procedure.

Instructions may include:

• Do not eat or drink anything after midnight on the day before surgery.
• Stop taking medications such as aspirin or ibuprofen.
• Remove a splint or a cast.
• If you are having general anesthesia, prepare to have someone drive you home after surgery. You will not be able to drive for 24 hours.

What to Expect During a Tendon Transfer Surgery

Tendon transfer surgery will be performed either under general anesthesia, where you will be asleep or under mild sedation. Your doctor will determine which option is best for your case.

During the surgery, your orthopedic surgeon will make several cuts in the skin to locate the affected tendon. The surgeon will move the tendon and sew it to the tendon that is not working. 

In some cases, your doctor will drill a tunnel to allow the tendon to pass through and sewn onto itself. The tendon may be attached with a metal or plastic screw or attached with anchor sutures.

If you need multiple tendon transfers, your surgeon will move one at a time and then close the skin with stitches.

Duration of Tendon Transfer Recovery

After surgery, your doctor may recommend wearing a splint or brace to protect the new tendon until it heals into the new position. Typically, the process takes between one and two months. 

Typically, physical therapy is necessary to help rebuild the strength of the transferred muscle and help you regain mobility.

Follow your provider's instructions carefully to ensure a full recovery. Too much or too little movement in the affected area can delay healing.