Specialty Procedures
/Elbow • Hip • Shoulder • Knee • Foot/Ankle

Percutaneous Tenotomy (TENEX)

The TENEX method is a minimally-invasive, ultrasound guided procedure designed to help patients suffering with chronic tendon pain. Using this method, degenerative scar tissue that has formed within the tendons of the shoulder, ankle, knee, hip and elbow can be located and removed. In addition to removing the damaged tissue that is causing pain, the procedure also stimulates the body’s natural healing response. Recovery time following this procedure ranges from four to six weeks.

Who Needs It

The TENEX procedure is specifically designed for individuals who are experiencing pain associated with a damaged tendon(s). Some of the issues that Dr. Hackel uses this procedure to address include:

  • Tennis elbow;
  • Rotator cuff tendonitis;
  • Patellar tendonitis (jumper’s knee);
  • Golfer’s elbow;
  • Plantar fasciitis;
  • Achilles tendonitis; and
  • Gluteus medius/minimus tendonitis.

The ideal candidate for this procedure is someone who has previously sought non-surgical treatment, such as steroid injections, immobilization, rest and rehabilitation but found little to no relief.

How Does It Work

During the TENEX procedure, ultrasound imaging is used to find the degenerative tendon tissue responsible for the pain a patient is experiencing. Once the degenerative tissue causing the pain is located, a small (4mm) incision is created. Then, Dr. Joshua G. Hackel uses TENEX’s ultrasonicdevice, which is a small instrument that vibrates at very high ultrasonic frequencies, to break down and then simultaneously remove the damaged tissue through the tip of the device. By targeting and then removing degenerative scar tissue, the tendon can heal properly, and the patient experiences pain relief.

The TENEX method of scar tissue removal only requires the use of local anesthesia. It is also performed as an outpatient procedure that usually takes no more than 15 minutes to complete. Some benefits of the TENEX procedure include a quick recovery, no need for stitches, the patient’s healthy tissue remains unharmed, minimal scarring and fast pain relief. All of this is achieved without undergoing conventional surgery or anesthesia.