Tendon transfer surgery uses a functioning donor tendon to restore the movement (recipient) that no longer works, helping you regain grip, pinch and coordinated elbow, wrist or hand use.
It is a precise, personalised procedure designed to improve daily independence when nerve damage, muscle loss or tendon rupture or has made certain movements difficult or impossible.
Procedure Time
1 – 2 hours, depending on the number of transfers.
Anaesthetic
Local, WALANT or regional anaesthetic
Recovery
Splinting for up to 6 weeks; guided therapy over 8 – 12 weeks; continued refinement over several months.
Full Results
Functional improvement develops over 3 – 6 months as strength and coordination return.
A working tendon is re-routed to restore the lost action, helping recreate purposeful movement of your wrist, fingers or thumb.
Transfers can restore function, eg for grip, pinch, hand opening, wrist and elbow flexion, making practical tasks easier and more natural.
Correcting abnormal posture – such as clawing, failure of thumb opposition or inability to open your hand – helps restore comfort and function.
Donor tendons are chosen carefully so that their original function can be spared safely.
Restoring motion often helps people return to work, hobbies and daily activities with greater ease.
We support you through surgery and beyond
Your consultation focuses on understanding which movements are weak or lost, how these affect your daily life, and what goals matter most to you. Your surgeon will examine your hand and arm strength, joint stability and soft-tissue health to determine which transfers will provide the most balanced, natural movement. You’ll receive clear guidance on the recommended procedure, expected recovery and how important therapy will be after your procedure.
To prepare safely:
Tendon transfer surgery happens mostly under local or regional anaesthetic, where possible using the WALANT technique, so movement can be checked during the procedure. Small incisions are made to detach the chosen donor tendon and reattach it to the non-functioning muscle’s tendon. Precise tensioning ensures smooth, effective movement. A light splint or cast is applied to protect the repair, and most people go home the same day.
Your hand or wrist will be protected in a splint for 3 – 4 weeks to allow the transfer to heal. Therapy begins early with gentle, guided exercises to retrain the transferred tendon to perform its new action. Strength and coordination improve over the following months, and most people regain practical, functional use by 8 – 12 weeks. Full refinement of movement continues over 3 – 6 months, depending on the complexity of the transfer and your therapy programme.
At The Antler Clinic, your care is led by Mr David Izadi, an experienced Consultant Plastic, Reconstructive and Hand Surgeon with over 20 years of specialist experience in complex hand, peripheral nerve, and reconstructive surgery.
Mr Izadi is one of only a small number of surgeons in the UK who regularly performs tendon transfer surgery in both NHS and private practice. He specialises in the restoration of upper limb function following nerve injuries, brachial plexus injuries, tendon injuries, paralysis, and complex neurological conditions. Tendon transfer surgery is a highly specialised field that requires a detailed understanding of anatomy, biomechanics, and hand function, using carefully selected functioning tendons to restore movement while preserving existing strength and function.
He completed prestigious hand surgery fellowships at two of the world’s leading hand surgery centres – The Pulvertaft Hand Centre, Derby, and Institut de la Main, Paris – where he developed advanced expertise in reconstructive hand surgery and functional restoration. He is also a core member of the Warwickshire Hand Surgery Multidisciplinary Team (MDT), delivering safe, evidence-based care through collaborative specialist decision-making.
Known for combining technical excellence with a calm, honest, and patient-centred approach, Mr Izadi takes time to understand each patient’s goals and priorities. Every treatment plan is individually tailored, with a focus on restoring movement, maximising independence, reducing disability, and helping patients return to the activities that matter most.
A quick guide to the things most people want to know before and after their procedure.
Tendon transfer surgery uses a working muscle to restore the movement of a muscle that no longer functions because of nerve injury, muscle loss or tendon rupture.
After your tendon transfer surgery, the surgery site is protected in a splint for typically 3 – 4 weeks, followed by a period of structured therapy. Most people regain functional use within 8–12 weeks, with continued improvement over several months.
The 3-5-7 rule for tendon transfer refers to the typical timeline for healing and retraining:
It means: 3 weeks of protection, 5 weeks to begin controlled movement, and 7 weeks to start strengthening. Your exact plan will be personalised to your specific needs.
Most people experience mild to moderate discomfort in the first few days after their tendon transfer surgery. Using WALANT or regional anaesthetic keeps the procedure comfortable. Suitable pain relief will be given after every surgery.
Risks of tendon transfer surgery include stiffness, swelling, reduced motion, over- or under-tensioning, rupture, infection or incomplete improvement. The brain will have to relearn the movement, making therapy essential for functional gains. We’ll make sure to discuss all of the risks with you at your consultation.
Donor tendons are chosen because their original function can be spared safely. Some mild loss of strength is possible after tendon transfer surgery, but most people don’t notice a significant deficit. The strength of the new function of the tendon will improve with hand therapy input.
After your tendon transfer surgery, your hand will be splinted at first. Guided therapy begins early, with gradual progression to functional use over several weeks.
You could benefit from tendon transfer surgery if you have radial, median and ulnar nerve palsies; tendon rupture; congenital differences; and muscle loss from injury or disease.
Success rates of tendon transfer surgery are high when performed by an experienced reconstructive surgeon and supported by proper therapy after your procedure.
clear and transparent costs
You will receive a clear quotation setting out the cost of your treatment and what is included before you decide whether to proceed.
A new consultation is charged at £200.
Follow-up consultations are charged at £150, unless the appointment forms part of an agreed surgical package or postoperative follow-up pathway.
Consultation fees are payable regardless of whether surgery is subsequently arranged. A consultation provides assessment, advice and discussion of treatment options; it does not guarantee that surgery will be recommended or offered.
Patients are kindly asked to provide at least three working days’ notice if they need to cancel or rearrange an appointment.
Non-attendance, or cancellation with less than three working days’ notice, will incur a fee of £125. This fee reflects the clinical time reserved for the appointment and the difficulty of offering the appointment to another patient at short notice.
For self-pay patients, surgery is usually provided as a fixed-price package. This is intended to give patients clarity and reassurance about the cost of their planned procedure.
Your written quotation will confirm what is included. In most cases, the package price includes:
Hospital fees for the planned procedure
Surgeon’s fee
Anaesthetist’s fee, where applicable
Standard postoperative follow-up appointments relating to the procedure
Routine aftercare directly related to the planned surgery, as specified in your quotation
Package prices are based on the procedure agreed at the time of booking. If the surgical plan changes, if additional procedures are requested, or if further treatment is required outside the agreed package, additional fees may apply.
Self-pay surgical packages usually include a period of cover for the treatment of complications directly related to the procedure. The exact terms, duration and exclusions of this cover are set by the hospital where your surgery is performed.
Depending on the hospital, complication cover may apply for a defined period, which may be 6 or 12 months. Full details will be provided by the relevant hospital before surgery.
Complication cover is not a guarantee that all future treatment, revision surgery or additional procedures will be provided without charge. Cover may not apply to unrelated medical problems, pre-existing conditions, treatment required outside the hospital’s terms, or surgery requested for aesthetic preference rather than a recognised complication.
In an emergency, patients should seek urgent medical attention through the most appropriate service, including NHS emergency care where necessary.
Every effort is made to achieve the best possible outcome, but no surgical procedure can guarantee a specific result, perfect symmetry, invisible scarring or complete satisfaction. Healing, scarring, swelling and final results vary between individuals.
If revision surgery is required because of a complication, eligibility for cover will depend on the hospital’s package terms and the clinical circumstances.
If surgery has been performed to an appropriate clinical standard, but a patient remains dissatisfied with the aesthetic outcome or wishes to pursue further refinement, any revision or additional surgery will usually incur further charges. These may include hospital fees, surgeon’s fees and anaesthetic fees.
Unless specifically included in your written quotation, additional costs may apply for investigations, scans, specialist opinions, extra procedures, further hospital admissions, prescriptions, dressings, garments, travel, accommodation, time off work or treatment unrelated to the planned surgery.
The written quotation and the hospital’s own terms and conditions will take precedence over any general information provided on this website.
Payment terms, deposits, cancellation policies and refund arrangements are determined by the hospital where your procedure is booked. These will be provided to you before surgery.
Surgery can only proceed once all required payments have been received and all relevant consent, preoperative assessment and hospital requirements have been completed.
To help make treatment more affordable, you may choose to spread the cost of your procedure through a personal medical loan with Chrysalis Finance. Subject to eligibility and approval, Chrysalis offers a range of flexible finance options, allowing you to pay for your treatment in manageable monthly instalments rather than a single upfront payment.
The hospitals we work with offer finance options through Chrysalis Finance. Please contact your chosen hospital directly for further information or to discuss any questions.
Mr Izadi is registered with the private medical insurers shown below. Coverage for consultations and treatment is subject to the terms of your policy and insurers approval.
Get in Touch
A consultation at The Antler Clinic is simply a chance to talk – to ask questions, explore your options, and decide what feels right for you.
You’ll leave with clarity, reassurance, and the same calm support that defines everything we do.
