Ultrasound percutaneous tenotomy for epicondylitis

Background: Definitive management of chronic tendinopathy is problematic in general and no less so at the elbow. Rationale: With increased accuracy of localization by ultrasound guidance, a novel percutaneous tenotomy technique using ultrasound energy has been developed. Procedure: The technique is straight forward. After identifying the pathology, the elbow is prepared in a manner similar to what is done for a cortisone injection. The percutaneous procedure is carried out under a local anesthesia, with the expenditure of energy usually <60 seconds. Patients tolerate the procedure extremely well and the puncture site is closed with a 5 mm Steristrip. Aftercare: Recovery is rapid. No additional adjunctive modalities have been employed. Results: With over 1000 cases performed in the United States, the ultrasound percutaneous tenotomy has been demonstrated to be well tolerated with no reports of significant complications to date. The recovery has been rapid and a success rate of 80% to 90% has been reported. Conclusions: The ulstrasound-guided percutaneous tenotomy using ultrasound energy appears to be a very promising and safe definitive procedure for chronic, lateral, and medial epicondylitis.