Post surgery for the tendons

You said:

I cut 2 tendons on my 2nd joint pinky finger. Then, I had a surgry to connects those tendons. Now, i want to understand the progress of the tendons recovery and strength as time goes. Especially, i'm interested to understand the pull strength and durability of the tendons. Could you plot the strength and time, each week up to 8 weeks how the tendons strength grow?

but

ChatGPT said:

ChatGPT

Memory updated

Tendon Strength Recovery Over 8 Weeks

Here is a plot showing the hypothetical recovery of tendon strength over 8 weeks. In the early weeks, the strength increases gradually, but after 4-6 weeks, there is typically a more rapid improvement in strength as the tendons heal and regain durability. By week 8, full recovery or close to full strength might be expected, although actual recovery rates can vary based on individual circumstances and rehabilitation efforts. ​​

4o

You said:

The doctor said that the tendons will hit the weakest strength 3 weeks after the surgery due to the reformulation occures on the tendons. How do you think?

ChatGPT said:

ChatGPT

The information your doctor provided is consistent with general medical knowledge about tendon healing. Tendon repair and recovery go through distinct phases, and the third week post-surgery is often a critical time. Here’s a breakdown of why the tendons are weakest around 3 weeks after surgery:

Tendon Healing Phases:

1. Inflammatory Phase (1-2 weeks):

   • Right after surgery, the tendon enters the inflammatory phase. During this time, the body works to clean up the damaged tissue and start the initial healing process.

   • The tendon is still fragile, but the early repair tissue is being laid down. This tissue, however, is not yet strong.

2. Proliferation or Collagen Formation Phase (2-4 weeks):

   • In this phase, new collagen (the protein that gives tendons strength) is produced. However, the collagen fibers are disorganized and not yet aligned properly to bear much load.

   • Around the 3-week mark, the newly forming tissue is more vulnerable because the initial healing tissue is being replaced by this weaker, immature collagen. This creates a temporary period of increased weakness as the body works to remodel the tendon.

3. Remodeling Phase (4-12 weeks):

   • During this phase, the tendon becomes stronger as the collagen fibers begin to align along the lines of stress. At this stage, tendon strength gradually improves.

   • With proper rehabilitation, the tendon will regain its tensile strength over the following weeks.

Why Tendons are Weakest Around 3 Weeks:

• Around the 3-week mark, the initial healing is being replaced by immature collagen fibers, which are not as strong or organized. This "remodeling" process leads to the temporary weakening of the tendon.

• Excessive stress on the tendons during this time can cause damage, which is why controlled motion and avoiding heavy strain is critical at this stage.

Importance of Care During Week 3:

• This phase requires caution with movements that might overstress the tendons.

• Gradual, guided physical therapy is usually introduced after this phase to promote proper tendon healing and strength recovery without causing reinjury.

After this critical phase, the tendons will slowly start to gain strength, especially if you're following a structured rehabilitation plan.

4o

You said:

Could you plot the tendons strength per week up to 14 weeks by considering such Inflammatory Phase, Proliferation or Collagen Formation Phase and Remodeling Phase?

ChatGPT said:

ChatGPT

Tendon Strength Recovery Over 14 Weeks

Here is the plot showing tendon strength recovery over 14 weeks, considering the three healing phases:

1. Inflammatory Phase (Weeks 1-2): The tendon strength increases slightly but remains very weak.

2. Proliferation/Collagen Formation Phase (Week 3): The tendon reaches its weakest point due to the immature collagen formation and remodeling.

3. Remodeling Phase (Weeks 4-14): After week 3, the tendon strength gradually improves as the collagen fibers realign and the tendon becomes stronger. By week 14, the tendon can reach near full recovery, around 100% of its pre-injury strength.

This provides a general idea of how tendon recovery progresses, but actual recovery can vary based on factors like the injury's severity, rehabilitation efforts, and individual healing rates. ​​

Actually, the doctor said that the tendons strength right after the surgery is as strong as the one with 6 weeks after the surgery. thought?

ChatGPT said:

ChatGPT

Your doctor's comment reflects an important aspect of tendon healing immediately after surgery, specifically the strength provided by the sutures (stitches) used to reconnect the tendon. Here's how this works:

Initial Tendon Strength After Surgery:

• Sutures: Right after surgery, the strength of the tendon is mainly due to the sutures holding the tendon together. These sutures are strong and provide immediate mechanical support to the tendon. The tendon itself, however, is still in the early stages of healing and is structurally weak.

• Artificial Strength: The repaired tendon has a relatively high strength initially, not because the tendon tissue itself is strong, but because the sutures are doing most of the work. This can give the tendon a level of stability and strength comparable to what is typically seen around week 6, when the collagen fibers begin to organize and contribute more to the tensile strength.

Strength Reduction After Surgery:

• Around week 3, as the sutures remain in place, the tendon enters the proliferation phase, where the initial repair tissue is being replaced by immature collagen. This can lead to a temporary drop in overall strength (even though the sutures are still present) because the new tendon tissue is weaker during this phase.

Recovery After Week 6:

• By week 6, the tendon tissue has undergone enough remodeling, and collagen fibers are starting to organize more properly, contributing to the strength. At this point, the tendon is beginning to rely more on its own tissue strength rather than the sutures alone.

How It Affects the Strength Curve:

• Right after surgery, the tendon is artificially strong due to the sutures, but as the healing tissue starts to remodel, the strength temporarily dips, and the tendon becomes weakest around the 3-week mark. By week 6, the strength would naturally reach a similar level again but now due to biological healing rather than just sutures.

Adjusted Tendon Recovery Timeline:

I'll update the plot to reflect the initial strength right after surgery being comparable to week 6, followed by the temporary drop in strength.

Adjusted Tendon Strength Recovery Over 14 Weeks

Here is the updated plot reflecting the tendon strength right after surgery being as strong as at week 6, largely due to the sutures. The plot then shows the typical weakening around week 3 as the new, immature tissue forms. After week 3, the strength gradually recovers as the tendon heals biologically, eventually reaching full strength by week 14.

This adjusted curve better aligns with what your doctor mentioned regarding the tendon strength post-surgery. ​​