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Tendon debridement is a surgery to remove inflamed tissue from around a tendon to allow it to heal. This procedure is most commonly recommended in the treatment of Achilles tendinitis, a condition involving a key tendon in the lower leg. Patients who do not respond to nonsurgical treatment measures may need more aggressive therapies like debridement in order to recover. A foot and ankle specialist may perform the procedure, although surgeons in other disciplines may be qualified to do it as well.
Before a surgeon will recommend a tendon debridement, a careful patient evaluation is required. Generally patients need to have a history of tendinitis, with a record of nonsurgical treatments like icing, physical therapy, and medications. If these treatments didn’t work, the patient may be considered a candidate for surgery, particularly for people who want to be able to resume high activity levels. Medical imaging studies can provide more information about the extent of the damage, and assist with surgical planning.
In the surgery, the doctor makes an incision along the length of the tendon in order to access it. The length of the incision depends on the tendon involved and the level of inflammation. Next, layers of inflamed, thickened tissue are carefully stripped away. Surgeons take this opportunity to physically evaluate the tendon and make some incisions into it to stimulate healing and the production of new tissue. When they are satisfied with the tendon debridement, they can close the incision.
After a tendon debridement procedure, patients usually need to rest and elevate the leg. Pain medication and anti-inflammatory drugs can increase comfort, and the surgeon may recommend a walking boot for several days or weeks to support the leg while the tendon heals. The goal of the surgery is to prevent a full rupture of the tendon, and thus the patient needs to avoid strain while it is fragile. Physical therapy can also be a part of the post-surgical plan, to help develop strength and flexibility.
Caring for the leg after tendon debridement is important to limit the chances of complications. If the tendon ruptures, a repeat surgery to repair it will be necessary. This surgery can have a lengthy recovery time as well as being very invasive, and may limit postsurgical mobility more than a debridement. Other surgical options may be available as well to treat inflammation, depending on the nature of the patient’s case and a surgeon’s level of experience.