What is Tendonorrhaphy?
Tendonorrhaphy is a surgical procedure that involves repairing a ruptured tendon. Tendon rupture occurs when the tendon separates from the bone or from itself. This separation can be partial or total. Since tendons do not heal by themselves, surgery is required to restore function to the tendon and relieve the dog’s pain. Tendonorrhaphy can be performed on virtually any tendon in the body, but is commonly used to treat ruptured Achilles tendons. Ruptured tendons are usually caused by traumatic injury, although some can be the result of degenerative disease.
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Tendonorrhaphy Procedure in Dogs
The approach to the procedure will vary depending on the location of the ruptured tendon, the expertise of the surgeon, and the extent of the rupture. The general procedure steps for tendonorrhaphy to treat a ruptured Achilles tendon are outlined below.
- The dog’s blood will be analyzed to make sure it is safe to administer general anesthesia.
- General anesthesia is given intravenously.
- The surgeon will incise the skin and subcutaneous tissues near the Achilles tendon.
- The damaged tendon is cut and sutured back together.
- If the tendon has separated from the bone, a bone drill may be used to bore small holes into the bone, allowing the tendon to be sutured back in place.
- A graft may be applied to protect the tendon and promote healing.
- Once the tendon has been restored to its normal position, the bone and tendon are stabilized using an external skeletal fixator or a cast. The external skeletal fixator is usually the method of choice.
- The incision is then closed.
- The dog may be hospitalized to ensure postoperative infection or complications do not occur.
Efficacy of Tendonorrhaphy in Dogs
Tendonorrhaphy is usually very effective for repairing ruptured tendons. However, the efficacy will vary based on how quickly the dog was diagnosed and treated. Tendonorrhaphy is less successful in cases where scar tissue has formed. There are few postoperative complications associated with this procedure. Most complications that occur after surgery are related to a premature return to regular activity or improper fixator care. The surgeon will provide explicit instructions on how to clean and maintain the external skeletal fixator.
Tendonorrhaphy Recovery in Dogs
Owners must follow their surgeon’s recovery instructions explicitly to prevent further complications and improper healing. Pain management medications are prescribed for the first two weeks after surgery. On the return home, exercise should be prohibited. Strict cage rest is often recommended. If the dog has been fitted with an external skeletal fixator, the cage or crate should be padded. This prevents the dog from snagging one of the screws or pins on the bars of the crate, which could result in rupture recurrence.
The external skeletal fixator may be covered with a bandage to protect the pins from damage. The pins must be cleaned and bandages changed regularly according to surgeon instructions. If the pins are not well-maintained, infection and serious complications can occur. If owners have any questions about pin care and maintenance, or if they notice signs of infection, they should consult their trusted veterinary surgeon.
Follow-up x-rays are taken each month to assess healing until the external fixator is removed, usually after twelve weeks. As healing progresses, single screws or pins may be removed. Additional x-rays are taken four, six, and twelve months after surgery. Dogs will need to participate in physical therapy to restore normal function to the tendon.
Cost of Tendonorrhaphy in Dogs
The cost of tendonorrhaphy will vary based on the location and extent of the injury, standards of living, additional costs incurred. The price of tendonorrhaphy ranges from $1,000 to $4,000.
Dog Tendonorrhaphy Considerations
Complications with tendonorrhaphy, although rare, are possible. These typically include infection, delayed healing, and improper pin care. The importance of adequate external skeletal fixator maintenance cannot be stressed enough. If the fixator is not maintained properly, the tendon may take longer to heal. The healing process is already lengthy, at three to four months on average. Neglecting the fixator will result in longer healing times and more pain for the dog. Dogs should not return to regular exercise until instructed to do so by their veterinary physical therapist. This may also result in delayed healing.
Tendonorrhaphy Prevention in Dogs
Ruptured tendons are often the result of traumatic injury. Owners should make sure their dogs do not engage in activities that can increase a dog’s risk of tendon rupture. These include falling from heights, overstretching the tendon, and jumping incorrectly.