A simple technique for repair of chronic tendinopathy

A large number of tendon repair techniques have been described for acute tendon injury. However, after reviewing the literature, it was noted that there were limited descriptions of specific suture techniques that address repair processes of chronic tendon pathology. Generally, in chronic tendinopathy, others have described a process known as tendon tubularization, which consists of a running stitch using a nonabsorbable suture material along the external surface of the tendon. We believe that leaving a nonabsorbable suture on the exterior surface of the tendon in this manner has the potential to disrupt the optimal gliding function. Furthermore, because additional damage could be present within the body of the tendon, this form of repair might not prove adequate to optimally appose the disrupted tendon segments internally. We have described a simple technique to repair chronic tendon injury from "the inside-out." We believe this approach provides better augmentation of tendon strength and eliminates the nonabsorbable suture along the exterior surface of the tendon.