TENEX Ultrasound Guided Percutaneous Tenotomy

What is Tendonitis?
A tendon typically goes through 3 phases of healing; inflammatory, proliferative, and remodeling. Chronic tendinitis is a process of disordered healing, wherein there is an imbalance of breakdown and attempts at healing, leading to degeneration through the deposition of poor tissue elements.

How is Tendonitis treated?
Various nonsurgical options exist, including physical therapy which is typically effective. In certain tendons, cortisone injections can provide short term improvement but are often ineffective over extended periods of time. Alternative treatment options include percutaneous tenotomy and platelet rich plasma, where focal area or tendon degeneration are targeted. Ultrasound can be used in the office to diagnose chronic and guide procedures for chronic tendinitis.

What is Ultrasound-Guided Tenotomy?
Also called TENEX, this is accomplished through the use of high frequency ultrasound energy targeted at diseased tendon in order to break it up. The area is simultaneously irrigated with cool saline to then remove the diseased area of tendon. This is done under ultrasound guidance with a tiny incision to properly visualize the focal area of pathology.

What type of tendonitis is TENEX used for?
It is successfully used for the following diagnosis; tennis elbow/lateral epicondylitis, golfers elbow/medial epicondylitis, rotator cuff tendinitis, proximal bicep tendinitis, patellar tendinitis, hamstring tendinitis, achilles tendinitis, plantar fasciitis.

Is it painful and how quickly does it work?
The procedure is minimally invasive, not requiring any stitches but only steri-strips. It is a single treatment and lasts less than 5 minutes. It is done with only local anesthetic and patients tolerate it very well. The side effects are minimal, similar to that of a joint injection.
After the procedure, there is a brief 1-2 week period of unloading as the tendon begins to heal, followed by slow progression of activity with the goal of returning to full activity by 4-6 weeks from the procedure.


Dr. Moore has extensive experience with this technology and provides over 100 procedures annually.