Surgery for Wrist Tendonitis

Surgical treatment for wrist tendonitis is rare. However, surgery may be recommended in one or more of the following cases:

• Nonsurgical measures have failed to provide relief from symptoms for 3 to 6 months.¹Wilson JJ, Best TM. Common overuse tendon problems: a review and recommendations for treatment. Am Fam Phys. Sep 1 2005;72(5):811e8.
• The type or severity of tendon injury may put the tendon at an increased risk of tears in the long term.
• The tendon is chronically degenerated (tendinosis) and has not responded to non-surgical treatment measures.

See What Is the Difference Between Tendonitis, Tendinosis, and Tendinopathy?

In such cases, surgery may be a better option to resolve symptoms and restore functionality of the tendon.

See Soft Tissues of the Wrist

The goals of wrist tendon surgeries are to:

• Remove damaged tissues from the site of tendon injury.²Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence?. Clin Sports Med. 2012;31(2):329-50.
• Increase blood flow to the site of injured tendon.²Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence?. Clin Sports Med. 2012;31(2):329-50.
• Stimulate the influx of cells that encourage healing. For example, cells called tenocytes help synthesize proteins, which in turn repair the injured tendon(s).²Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence?. Clin Sports Med. 2012;31(2):329-50.

Several arteries and nerves pass through the wrist and surgeons usually choose specific areas to operate in order to minimize damage to these tissues.

Doctors may use one of the following approaches while performing a wrist tendonitis surgery:

• Open surgery. In this type of surgery, an incision is made through the skin overlying the affected wrist tendon, sometimes extending into the hand or forearm. The size of the incision varies based on the specific condition and tendon being treated. Open surgery may be considered while treating the tendon along with its surrounding membranes, sheaths, or other structures. Examples of open surgical tendon procedures on the wrist include:
  • Tendon sheath release or releasing constricting tissue from around a tendon
  • Tenosynovectomy or releasing a tendon from surrounding inflammatory tissue and removing the inflammatory tissue
  • Tendon grafting or using a tendon from another body part to restore function in the wrist
  • Tendon transfer or moving a tendon to another area for better functionality of the joint
  • Tendon repair surgery, where a torn tendon is surgically repaired or re-attached to bone
• Minimally invasive procedures. These procedures can be performed using needles and small tubes without the need for large incisions. Minimally invasive surgeries for treating wrist tendonitis include:
  • Arthroscopic surgery. Arthroscopic surgery involves insertion of an arthroscope (small device with a lens and light) into the wrist. The arthroscope is connected to a video screen and monitor, which enables the doctor to view the inner structures and surgically treat the disorder. This technique is useful in debridement (the removal of fibrotic tissues, adhesions, and other tissues).
  • Tenotomy. A tenotomy is a form of minimally invasive surgery that involves insertion of needles into the wrist in order to cut a tendon. The procedure may involve the use of ultrasound or x-ray guidance to guide the needle into the area to be treated.

As with any surgery, complications can occur. Infection, nerve damage, scar tissue formation, and wrist stiffness may result after wrist tendon surgery.

Recovery After Wrist Tendonitis Surgery

In general, wrist tendonitis surgeries heal well and have good long-term results. Almost 95% of cases recover after a tendonitis surgery. The recovery time usually takes 3 to 4 weeks.¹Wilson JJ, Best TM. Common overuse tendon problems: a review and recommendations for treatment. Am Fam Phys. Sep 1 2005;72(5):811e8.

Recovery After Wrist Tendinosis Surgery

Compared to tendonitis, it takes longer to recover from a tendinosis surgery. This is because the tendon in tendinosis is degenerated and new cells and tissues need to build up and restore the entire tendon mass. The goals and techniques of wrist tendinosis surgery are similar to wrist tendonitis surgery.

The average recovery time for wrist tendinosis surgery is 4 to 6 months. Studies show an estimated 70 to 85% of cases recover after a tendinosis surgery without complications.¹Wilson JJ, Best TM. Common overuse tendon problems: a review and recommendations for treatment. Am Fam Phys. Sep 1 2005;72(5):811e8. Some degree of stiffness may be common after surgery.

After wrist tendonitis or tendinosis related surgery, a cast or splint is usually applied to prevent wrist movement. Physical therapy is often advised for restoring movement, strength, and functionality in the wrist.