tenolysis

Tenolysis is the surgical release of mature peritendinous adhesions that restrict tendon gliding after a primary repair or tendon graft. The operative criteria are strict: full passive range of motion (confirming that the joint itself is not stiff), restricted active range of motion (confirming that adhesions are limiting tendon excursion), an intact underlying repair (confirmed clinically and where necessary by imaging), and a patient who can commit to the demanding postoperative therapy. The operation is performed at least six months after the index repair to allow the adhesions to mature and the original construct to reach full strength. Tenolysis on a non-compliant patient or on a partially failed repair will not improve function and may worsen it. The operation can be performed under WALANT to allow intraoperative testing of regained tendon excursion.