Tendon Repair at Apollo Hospitals, Lucknow

Why Patients Choose Apollo Hospitals Lucknow for Tendon Repair

• Part of the Apollo Hospitals group, founded in 1983 ? over four decades of clinical experience in India and one of the country's largest multi-speciality hospital networks, with more than 70 hospitals and over 10,000 beds.
• A dedicated Orthopaedics, Sports Medicine and Trauma department at the Lucknow unit, with a multi-member team of orthopaedic and hand surgeons supported by plastic and reconstructive surgery, anaesthesia, radiology and physiotherapy ? the exact number of consultants on duty and their combined years of experience are best confirmed with the department at the time of booking, as the panel changes.
• Full tendon spectrum under one roof ? flexor and extensor tendon repair of the hand, Achilles tendon repair, rotator cuff repair, patellar and quadriceps tendon repair, biceps tendon repair, peroneal and tibialis posterior tendon procedures, and tendon transfer or grafting for older, retracted injuries.
• Modular operating theatres with laminar airflow and image intensifier (C-arm) support, plus arthroscopy towers for minimally invasive rotator cuff and ankle tendon work, and an operating microscope or loupe magnification for microsurgical hand tendon and nerve repair.
• On-site diagnostics ? high-resolution musculoskeletal ultrasound and MRI, so tendon gap, retraction and tear size can be measured before surgery rather than assumed.
• 24x7 emergency and trauma access, which matters because sharp cut injuries to hand tendons are best explored within days, not weeks.
• Structured, phase-based rehabilitation run with physiotherapists and, for hand cases, hand-therapy splinting protocols ? including separate pathways for adults, children, older adults with degenerative tendons, and recreational or competitive athletes.
• Insurance and TPA desk on site for cashless pre-authorisation, plus support for patients travelling in from districts across Uttar Pradesh.

Overview

Tendon repair is a surgical procedure aimed at restoring the function of damaged tendons, which are essential for movement and stability in the body. At Apollo Hospitals Lucknow, our orthopaedic and hand surgery teams offer advanced care and technology with the aim of achieving the best achievable outcome for each patient. Treatment plans are individualised ? the surgery for a clean glass-cut flexor tendon in a 22-year-old differs substantially from a degenerative, retracted rotator cuff tear in a 65-year-old.

Our team is committed to personalised assessment, honest counselling about what surgery can and cannot achieve, and long-term rehabilitation support. Outcomes depend on the tendon involved, the age and quality of the injury, associated nerve or bone damage, and ? very importantly ? the patient's participation in therapy afterwards.

Why Tendon Repair is Necessary

Tendons are fibrous tissues that connect muscles to bones, playing a vital role in facilitating movement. Injuries to these structures can occur due to trauma, overuse, or degenerative conditions, leading to pain, weakness, and impaired mobility. Tendon repair is generally undertaken to restore function, reduce pain, and prevent further complications.

The potential benefits of tendon repair include:

• Restoration of Function: Repairing the tendon aims to restore movement and strength, though the degree of recovery varies.
• Pain Relief: Surgical intervention can significantly reduce pain associated with tendon injuries in many patients.
• Prevention of Further Damage: Timely repair may prevent the injury from worsening, which could otherwise lead to more complex surgeries or long-standing problems.

At Apollo Hospitals Lucknow, current techniques and technologies are used with the aim of delivering appropriate care for each tendon injury.

Risks of Delay

Delaying tendon repair can lead to complications. When a tendon is not repaired in a timely manner, the following risks may arise:

• Chronic Pain: Prolonged injury can lead to persistent pain that may not respond well to conservative treatments.
• Loss of Function: The longer the tendon remains damaged, the harder it can be to regain full function.
• Muscle Atrophy: Inactivity due to pain or dysfunction can lead to muscle wasting, complicating recovery.
• Increased Surgical Complexity: Delayed repairs may require more extensive surgery ? such as tendon grafting or transfer ? with longer recovery and a higher risk of complications.

We therefore encourage timely assessment of tendon injuries. Our team can guide you through evaluation and, where surgery is indicated, through the surgical and rehabilitation pathway.

Benefits of Tendon Repair

Undergoing tendon repair at Apollo Hospitals Lucknow may offer:

• Improved Mobility: Many patients experience meaningful improvement in movement and daily activity after surgery and rehabilitation.
• Improved Quality of Life: With reduced pain and restored function, patients can often return to their usual routines.
• Personalised Rehabilitation Plans: Our team develops tailored rehabilitation programmes to promote healing and strength.
• Access to Advanced Technology: Modern surgical techniques and equipment are used to support high standards of care.

Choosing Apollo Hospitals Lucknow means choosing a facility that prioritises your health, safety and long-term function.

Preparation and Recovery

Preparing for tendon repair surgery is important for a good outcome. The following practical steps help.

Preparation Tips

• Consultation: Schedule a thorough consultation with our orthopaedic specialists to discuss your condition and treatment options.
• Preoperative Instructions: Follow all preoperative instructions from your surgeon, including fasting, dietary restrictions and medication management.
• Arrange Transportation: Plan for someone to bring you home after surgery, as you may have had anaesthesia.
• Home Preparation: Set up a comfortable recovery area at home with necessary items within reach.

Recovery Tips

• Follow Postoperative Instructions: Adhere to guidance on wound care, medication, splint use and activity restrictions.
• Physical Therapy: Engage in physiotherapy or hand therapy as recommended to aid recovery and regain strength.
• Rest and Elevation: Allow healing time and keep the affected limb elevated as advised.
• Monitor for Complications: Watch for signs of infection or unusual symptoms and contact your treating team if concerned.

We aim to support you throughout recovery with the resources and guidance needed for a smooth return to daily life.

Current Clinical Guidance Informing Care

Tendon repair practice in India draws on national and international evidence, and recommendations have shifted in some areas over the last decade.

• Indian Orthopaedic Association (IOA) and its affiliated bodies ? the Indian Society for Surgery of the Hand (ISSH), the Indian Arthroscopy Society (IAS) and the Indian Foot and Ankle Society (IFAS) ? provide the main Indian professional forums for tendon and sports-injury practice, with annual instructional courses and consensus updates.
• Achilles tendon rupture: the American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guideline on Acute Achilles Tendon Rupture (2021) concluded that both operative and non-operative treatment can give comparable functional results in appropriately selected patients, with surgery carrying a lower re-rupture rate but a higher rate of wound and nerve complications. This is the notable change from older practice, where surgery was near-automatic. The guideline also supports early functional rehabilitation and early weight-bearing in a boot rather than prolonged rigid casting.
• Rotator cuff tendon tears: the AAOS Clinical Practice Guideline on Management of Rotator Cuff Injuries (2019) supports non-operative care as reasonable first-line treatment for many degenerative tears, while noting that repair of full-thickness tears can improve pain and function, and that outcomes are less predictable with larger tears, older age, fatty muscle degeneration and diabetes.
• Hand flexor tendon injuries: practice has moved decisively towards multi-strand core suture repair with early active motion protocols, replacing older passive-motion-only regimes, as reflected in contemporary hand surgery literature and ISSH/ASSH teaching.
• Antibiotic prophylaxis and VTE prevention follow standard perioperative protocols; the WHO Surgical Safety Checklist is used routinely.

Guidelines inform, but do not replace, individual judgement. Your surgeon will explain why a particular approach suits your tendon, your age, your occupation and your general health.

Timing of Surgery and the Pre-Procedure Phase

Tendon injuries are unusual in that timing genuinely changes what operation is possible.

• Acute sharp injuries (hand cuts, glass, blade, machinery): ideally explored and repaired within about 1?2 weeks. Beyond roughly 3?4 weeks, the muscle shortens and the tendon retracts, often converting a simple repair into a two-stage graft.
• Acute Achilles rupture: decision usually taken within the first 1?2 weeks, since delayed presentation may need augmentation or transfer.
• Traumatic rotator cuff tear in a younger patient: earlier repair is generally favoured.
• Degenerative rotator cuff or tennis elbow type problems: a trial of physiotherapy, activity modification and sometimes an injection is usual before considering surgery.
• Contaminated or infected wounds: wound care and infection control come first; tendon reconstruction is staged later.

The Pre-Procedure Preparation Phase

1. Clinical examination, and imaging where needed ? ultrasound or MRI to define the tear, gap and muscle quality.
2. Pre-anaesthetic check-up with blood tests, blood sugar and HbA1c, ECG, and chest imaging where indicated.
3. Optimisation of diabetes, blood pressure, thyroid and anaemia ? poorly controlled diabetes is a recognised risk factor for poor tendon healing and infection.
4. Review of blood thinners, and stopping them only on medical instruction.
5. Stopping tobacco, gutka, khaini and smoking ? nicotine impairs tendon and wound healing and is one of the few factors fully in the patient's control.
6. Skin check for boils, fungal infection or cracked heels, which can postpone surgery.
7. Fitting or ordering the splint, brace or walker boot in advance.
8. Consent discussion covering realistic expected function, re-rupture risk and the length of rehabilitation.

Technique Options: A Comparison

Procedures Sometimes Performed at the Same Time

• Nerve repair ? digital or median/ulnar nerve injury commonly accompanies hand tendon cuts.
• Artery repair when circulation to the finger is compromised.
• Pulley reconstruction in the fingers to prevent bowstringing.
• Fracture fixation where the injury involves bone, or bony avulsion of the tendon.
• Subacromial decompression, acromioplasty or biceps tenodesis alongside rotator cuff repair.
• Debridement of degenerate tendon tissue and calcium deposits.
• Skin cover ? local flap or graft where soft tissue has been lost.
• Wound washout and staged repair for contaminated injuries.

Phase-by-Phase Recovery Timeline

This is a general guide. Your actual timeline depends on which tendon was repaired, the technique used and your healing.

Criteria for Returning to Work, Driving and Sport

Return is decided by milestones achieved, not by the calendar alone. Commonly used criteria include:

• Wound fully healed, no swelling, no pain at rest.
• Near-symmetrical range of motion compared with the opposite side.
• Strength usually within about 10?20% of the uninjured side on testing.
• For the lower limb: comfortable single-leg heel raises, hopping and change of direction without pain or apprehension.
• For the hand: adequate grip and pinch strength for the specific job ? a tailor, a cook and a labourer have different thresholds.
• Driving: only when out of a splint or boot, off sedating painkillers, and able to control the vehicle in an emergency stop. Two-wheeler riding is usually delayed further because of fall risk.
• Desk work: often within a few weeks; heavy manual or field work: often 4?6 months or more.

Your surgeon and physiotherapist will confirm clearance. Returning early is the single most common cause of a repair failing.

Indian Lifestyle Considerations After Tendon Repair

Many recovery instructions written abroad ignore how Indian households actually function. These points are discussed openly in our clinics:

• Squatting and Indian-style toilets: after Achilles, patellar, quadriceps or ankle tendon surgery, deep squatting loads the repair heavily. A Western-style commode or a commode chair over the Indian pan is usually advised for the first 3 months, and sometimes longer.
• Sitting cross-legged (sukhasana) on the floor for meals, prayer or family gatherings ? usually restricted early, and resumed gradually only once the surgeon permits.
• Floor sleeping and getting up from a mattress on the floor: a cot or a firm raised bed is safer during the splint period, especially for older patients.
• Stairs and terraces: many homes in Lucknow and surrounding districts have steep, narrow stairs without handrails. Arrange ground-floor living for the first few weeks after lower-limb tendon surgery.
• Kitchen and household work: after hand tendon repair, rolling chapatis, wringing clothes, grinding on a sil-batta, lifting a pressure cooker or carrying buckets are all high-load tasks and must wait for clearance.
• Bathing: bucket baths with the limb wrapped and kept out of water are usually easier than showers during the splint phase.
• Joint family caregiving: a real advantage ? identify one primary attendant who comes to the follow-up visits and understands the splint, exercises and warning signs, rather than rotating relatives who each get partial information.
• Religious and festival activities: prolonged kneeling, prostration, temple stair climbing or carrying heavy items during festivals should be discussed with your team beforehand.
• Diet: adequate protein ? dal, paneer, eggs, milk, soya ? supports healing, alongside control of blood sugar. Vitamin D and calcium status is often checked, as deficiency is common in this region.

Preventing Re-Rupture and Recurrence

• Complete the full rehabilitation programme ? stopping physiotherapy once pain settles is a frequent cause of re-injury.
• Wear the splint or boot exactly as instructed, including at night if advised.
• Avoid sudden, unplanned loading ? jumping off a bus step, catching a falling child, a slip on a wet bathroom floor.
• Warm up before sport and progress training loads gradually rather than in jumps.
• Manage diabetes, obesity, thyroid disease and high cholesterol, all linked to poorer tendon quality.
• Avoid repeated corticosteroid injections directly into weight-bearing tendons.
• Use quinolone antibiotics cautiously if you have a history of tendon problems, as they carry a recognised tendon-rupture association ? always mention this history to any doctor.
• Stop smoking and tobacco use permanently.
• Correct footwear, and treat heel pain or recurrent ankle sprains early.

Children, Older Adults and Athletes

Children

Children commonly sustain hand tendon injuries from glass, kite string (manjha), fans and kitchen accidents. Injuries can be missed because a child will not cooperate with examination, so a low threshold for exploration is used. Children generally heal well and develop fewer adhesions, but compliance with splints is harder, so more protective immobilisation and parent-supervised therapy is often needed. Growth plates are protected during any bony fixation.

Older Adults

Tendons degenerate with age, so tears often occur with minor trauma and tissue quality at surgery may be poor. Repair may need augmentation, and in some cases a non-operative or debridement-only approach gives comparable satisfaction with less risk. Diabetes, kidney disease, osteoporosis, poor vision and fall risk all influence the decision. Preventing stiffness, chest infection, pressure sores and delirium during immobilisation matters as much as the repair itself.

Athletes and Physically Active Patients

Sportspersons and heavy manual workers usually need repair rather than conservative care, followed by a criteria-based, sport-specific programme. Return to competitive sport after major tendon repair is often 6?12 months, and a proportion of athletes do not regain their previous level ? this is discussed honestly before surgery.

What Happens If You Choose Not to Have Surgery

Declining surgery is a legitimate choice, and for some tendons it is a reasonable one. What follows depends on the tendon:

• Cut hand flexor tendon: the finger will not bend actively at that joint. Function is permanently reduced, and late reconstruction is harder and less rewarding.
• Achilles rupture: non-operative functional rehabilitation in a boot can give good results in selected patients, with a somewhat higher re-rupture rate and often some loss of push-off strength.
• Degenerative rotator cuff tear: many people manage well with physiotherapy and pain control. Some tears enlarge over time and the muscle degenerates, after which repair may no longer be possible.
• Patellar or quadriceps tendon rupture: without repair, straightening the knee against gravity is usually not possible, and walking is significantly impaired.
• General consequences of no treatment can include stiffness, weakness, altered gait or grip, compensatory pain elsewhere, and reduced earning capacity in manual occupations.

Your surgeon will lay out the realistic non-surgical pathway so you can weigh it against surgery.

Factors That Influence the Cost of Tendon Repair

We do not publish figures here, as the final estimate is individual. Please ask the reception or billing desk at Apollo Hospitals Lucknow for a written estimate before admission.

Insurance, Cashless Treatment and TPA Process in India

• Accident versus planned cover: tendon injuries from an accident, cut or fall are usually admissible from day one of the policy, since accidental injury is generally not subject to the initial waiting period. Degenerative tendon problems treated electively may attract the standard 30-day initial waiting period and, in some policies, longer waiting periods for specified orthopaedic conditions or pre-existing disease (commonly 24?48 months). Check your own policy wording.
• Cashless treatment: available if Apollo Hospitals Lucknow is in your insurer's or TPA's network. Pre-authorisation is needed ? ideally 48?72 hours before planned surgery, and within 24 hours of admission in an emergency.
• Documents usually required: policy or e-card, government photo ID (Aadhaar/PAN), the treating doctor's advice note, investigation reports, and for accidents a description of how the injury occurred (a police report or MLC may be requested for road traffic and assault cases).
• Reimbursement route: if cashless is unavailable or declined, pay and claim later with the discharge summary, original bills, payment receipts, investigation reports and implant stickers or invoices.
• Commonly not covered or partly covered: braces, splints, walker boots, outpatient physiotherapy after discharge, consumables listed as non-payable, and room-rent charges above your eligible category ? which can proportionately reduce the entire claim.
• Government and employer schemes: Ayushman Bharat PM-JAY, CGHS, ECHS, state and PSU schemes have their own empanelment status, package rates and referral requirements. Please confirm current empanelment and applicability with the insurance desk at the hospital, as this changes over time.
• Day-care procedures: most modern policies cover listed day-care surgeries without a 24-hour admission, but confirm this in advance.

Our insurance and TPA desk can guide you on pre-authorisation, documentation and estimates. Approvals and co-payments are decided by your insurer, not by the hospital.

Planning Your Admission and What to Bring

• Government photo ID for the patient and the attendant.
• Insurance card, policy documents and the TPA pre-authorisation letter if issued.
• All previous prescriptions, X-rays, ultrasound or MRI films and reports, and discharge summaries.
• A written list of current medicines with doses, including ayurvedic and homeopathic preparations and supplements.
• Loose, front-open clothing ? an ordinary kurta or shirt is far easier over a splinted arm than a T-shirt; loose pyjamas or a lungi for lower-limb surgery.
• Slip-on footwear with a back strap; avoid unstable slippers if you will be on crutches.
• Crutches, walker or the prescribed boot, if already arranged.
• Toiletries, towel, spectacles, dentures, mobile phone and charger.
• Modest cash or card for incidentals and pharmacy items.
• Follow fasting instructions strictly ? usually no solid food for 6?8 hours and no clear fluids for 2 hours before surgery.
• Remove jewellery, bangles, kada, nail polish, mehendi on the operative limb, and artificial nails.
• Arrange one reliable attendant who can stay overnight and learn the splint and exercise instructions.

Warning Signs That Need Urgent Review

Contact the hospital or attend the emergency department promptly if you notice:

• A sudden "give way", pop or snap in the operated area, or sudden loss of a movement you had regained ? this may indicate re-rupture.
• Fever above 100.4?F (38?C), increasing redness, warmth, or pus or foul-smelling discharge from the wound.
• Wound edges separating, or blackening of the skin over the repair.
• Pain that is escalating rather than settling, or pain not controlled by prescribed medication.
• Fingers or toes that become numb, tingling, pale, blue, very cold or severely swollen ? the splint may be too tight.
• Calf pain and swelling, chest pain or breathlessness ? possible clot; seek emergency care immediately.
• The splint or cast becoming loose, broken, soaked or slipping off.
• Vomiting, confusion, or very high or very low blood sugar readings in a diabetic patient.

For Patients Travelling from Nearby Districts and Cities

Apollo Hospitals Lucknow receives patients from across Uttar Pradesh and neighbouring states ? including Kanpur, Unnao, Barabanki, Raebareli, Sitapur, Hardoi, Sultanpur, Ayodhya, Faizabad, Gonda, Bahraich, Balrampur, Basti, Pratapgarh, Jaunpur, Shahjahanpur, Lakhimpur Kheri, Amethi, Fatehpur, Bareilly, Gorakhpur, Varanasi, Prayagraj, and parts of Bihar, Uttarakhand and Nepal.

• Send reports ahead: share MRI, ultrasound and X-ray reports digitally before travelling so the consultation is productive on day one.
• Plan a two- to three-day first visit if surgery is likely ? consultation, investigations and pre-anaesthetic review often cannot be completed in a single day.
• Getting here: Lucknow is well connected by Chaudhary Charan Singh International Airport, Lucknow Charbagh and Gomti Nagar railway stations, and the Agra?Lucknow and Purvanchal Expressways.
• Accommodation: guest houses, lodges and hotels are available near the hospital; the front desk can suggest options, but bookings and tariffs are handled directly by those establishments.
• Follow-up planning: wound check and stitch removal at around 10?14 days usually needs a return visit. Later reviews may sometimes be managed with teleconsultation plus local physiotherapy ? discuss this with your surgeon so a local therapist can be briefed on the exact protocol.
• Local physiotherapy: ask for a written, phase-wise rehabilitation protocol in hand so your therapist at home follows the same plan.
• Long journeys after surgery: keep the limb elevated, move the toes or fingers periodically, and prefer a vehicle where the leg can be extended after lower-limb tendon surgery. Avoid two-wheeler travel entirely.

Contact and Appointments