Achilles Tendon Tenotomy
Achilles tendon tenotomy is a procedure performed by Dr. Julien Lopez, a foot specialist surgeon in Nice and Cannes.
Achilles tendon tenotomy is a surgical procedure involving the partial or complete release of the Achilles tendon, which connects the gastrocnemius and soleus muscles to the heel bone. This tendon lengthening procedure is often carried out in patients with a short Achilles tendon that affects walking and function. A short Achilles tendon is common in flat or high-arched feet, neurological foot conditions, after trauma, or in isolated cases without an identified cause. It leads to equinus and a tiptoe gait. The goal of Achilles tendon tenotomy is to allow tendon lengthening, thereby improving dorsiflexion of the foot and functional walking.
Julien Lopez, Specialist in Achilles Tendon Tenotomy Surgery
As an orthopedic surgeon, Dr. Lopez specializes in Achilles tendon tenotomy surgery. With expertise in minimally invasive surgical techniques, Dr. Lopez addresses various foot and ankle pathologies.
Tenotomy is a surgical procedure involving the cutting of a tendon to lengthen it, thereby releasing contractures and correcting deformities. The Achilles tendon, in particular, connects the calf triceps (calf muscle) to the calcaneus (heel bone), allowing foot extension.
How Lengthening Is Performed:
The most common technique is an open approach, requiring a several-centimeter incision. The tendon is cut in a Z-shape and then sutured end to end to achieve the desired lengthening effect.
The minimally invasive percutaneous technique uses millimeter-sized incisions to cut the tendon, which is not sutured.
What Is Percutaneous Achilles Tendon Tenotomy?
Percutaneous Achilles tendon tenotomy involves cutting the tendon through the skin using small instruments such as a needle or a small scalpel. The procedure involves locating the tendon beneath the skin and making 2 to 3 small skin incisions. The ankle is then immobilized in a boot that the patient must wear for several weeks. During this period, the cut tendon naturally heals while maintaining the length obtained during surgery.
This minimally invasive method is performed under local anesthesia and avoids the need for a large surgical incision. This procedure is often indicated for the treatment of acute Achilles tendon ruptures. Natural healing occurs, but rehabilitation is necessary to restore tendon strength and functionality.
Percutaneous tenotomy offers several advantages compared to the traditional method, which requires a large surgical incision.
Percutaneous surgery is less invasive, reducing tissue trauma and promoting rapid postoperative recovery. The procedure can be performed on an outpatient basis under local anesthesia, avoiding the risks associated with general anesthesia. Finally, postoperative rehabilitation is often shorter, allowing patients to resume their activities more quickly.
After an Achilles tendon tenotomy procedure, the patient must observe a recovery period to allow the tendon to heal. This recovery period also aims to restore normal foot function.
During this period, it is essential to strictly follow the practitioner's advice, particularly regarding postoperative care. Analgesic medications may be prescribed to relieve pain and reduce inflammation.
Once the patient is allowed to resume weight-bearing, rehabilitation exercises strengthen the muscles of the foot and ankle, improve mobility and flexibility, and help prevent recurrences. The recovery time may vary depending on associated surgical procedures and the patient's medical history. In most cases, sessions with a physical therapist are essential after an Achilles tendon tenotomy for a rapid functional recovery.
Tenotomy of Extensor Tendons of the Foot
The major flexor tendons of the foot are located in the leg and allow the foot to flex upward toward the leg. These muscles primarily consist of the tibialis anterior muscle, extensor digitorum longus muscle, and extensor hallucis longus muscle.
Tenotomy of the extensor tendons of the foot is a surgical procedure that involves cutting a tendon to reduce excessive tension on the Achilles tendon and improve foot function. This procedure is typically performed in patients with equinovarus foot deformity (clubfoot), a condition characterized by an abnormal downward and inward position of the foot.
Foot and Ankle Pathologies Requiring Percutaneous Tenotomy
Tenotomy is a surgical procedure performed on the foot and ankle to treat various pathologies, including clubfoot, Achilles tendon tendinopathy, hallux valgus, flat or high-arched feet, gastrocnemius contractures, and more.
Tenotomy of hallux valgus is a surgical procedure performed to correct the deviation of the big toe outward. In this context, tenotomy involves cutting the adductor hallucis muscle tendon. This tenotomy is part of the external release of the sesamoid-metatarsal band.
This tendon section helps release the tension exerted on the deviation of hallux valgus. Tenotomy is performed under local anesthesia in combination with other surgical procedures to correct the position of the big toe.
Following the procedure, full weight-bearing is immediate with a therapeutic shoe. Complete recovery takes several weeks and involves rehabilitation sessions and daily self-rehabilitation exercises.
Dr. Lopez performs percutaneous tenotomy of claw toes. Claw toe is a condition characterized by the progressive deformation of toes, typically the middle or smaller toes. The toes deform gradually, causing painful friction.
This condition can occur in isolation or in conjunction with hallux valgus (bunion) and can cause pain, difficulties in wearing shoes, or skin lesions. While conservative treatment is sufficient in rare cases, surgical treatment remains the most effective alternative. Through percutaneous claw toe tenotomy, the clawing can be effectively corrected.