Percutaneous tenotomy

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BACKGROUND: Tennis elbow (lateral epicondylitis elbow) is a self-limiting disease of indeterminate pathogenesis. Conservative therapy is the treatment of choice. In chronic tennis elbow with failure of conservative therapy; surgical treatment is a method of choice. Percutaneous tenotomy of extensor origin for patients with chronic tennis elbow is a minimally invasive technique with better long-term outcomes. CASE REPORT: Ten patients (six males, four females) presented with chronic tennis elbow, who did not respond to conservative treatment/non-surgical intervention for more than 6 months underwent percutaneous tenotomy in an outpatient setting...

PURPOSE: The aims of the study were to document the outcomes of percutaneous Achilles tenotomy (pAT) performed in older children with clubfoot, by assessing the clinical, functional and ultrasonographic evidence of Achilles tendon regeneration. METHODS: A retrospective case series of older children with clubfoot treated between August 2011 and July 2020 was studied. Clinical assessment of ankle range of motion and calf strength, functional assessment of triceps surae muscle endurance by single leg heel-rise test, and ultrasonographic assessment of Achilles tendon echotexture and dimensions to assess tendon regeneration were performed...

Calcification of the medial collateral ligament is a rare cause of medial knee pain along with functional impairment. Most cases are asymptomatic but those that are symptomatic typically respond to conservative management. However, in those instances with persistent symptoms that desire further intervention but want to minimize the risks associated with surgery, we present a novel approach for calcium removal with an ultrasound-guided percutaneous needle tenotomy with TenJet™ as a reasonable treatment modality...

OBJECTIVE: To describe the feasibility of a novel thread-transecting technique for the tenotomy of the equine deep digital flexor tendon (DDFT). ANIMALS: 39 equine distal limb specimens. METHODS: Under ultrasonographic guidance, a surgical thread was percutaneously placed around the DDFT through 2 needle punctures (lateral and medial) using a Tuohy needle in equine limbs (22 forelimbs, 17 hindlimbs). The DDFT was transected by a back-and-forth motion of the thread until the loop emerged from the entry puncture site...

Plantar fasciitis is one of the most common foot conditions presenting to a foot and ankle specialist. Surgical treatment outcomes following plantar fasciotomy vary but short-term studies have reported excellent early pain relief and significant improvements in symptoms. This study evaluates patient reported pain scores collected pre- and post-op for patients who underwent percutaneous ultrasonic micro-tenotomy (PUT) plantar fasciotomy with PRP injection vs without the use of PRP. We compared pain visual analog scale (VAS) scores, for patients treated surgically by Orthopedic Surgery department of foot & ankle faculty members between December 2007 and December 2022...

AIM OF THE STUDY: There is no consensus on the most suitable non-surgical treatment of chronic lateral elbow tendinopathy. The aim of this pilot randomized controlled trial was to evaluate the size of effect of ultrasound-guided percutaneous needle tenotomy. MATERIAL AND METHODS: Three intervention arms were formed: 1) percutaneous needle tenotomy, hydrodissection, and physiotherapy; 2) hydrodissection and physiotherapy; and 3) physiotherapy alone. Patients with chronic lateral elbow tendinopathy were randomized...

OBJECTIVE: To evaluate the feasibility and limitations associated with a minimally invasive ultrasound-assisted cutting thread technique for tenotomy of the deep digital flexor tendon (DDFT) in horses. STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Twenty cadaveric forelimbs. METHODS: Forelimbs were placed on a jig to mimic a standing semiflexed position and the midmetacarpal region was prepared to perform tenotomy of the DDFT using a percutaneous technique with a cutting thread...

INTRODUCTION: Overuse injuries such as tendinosis are a common complaint at sports medicine clinics. When conservative management for tendinosis has failed, ultrasound-guided tendon fenestration and injection procedures, such as dry needling, needling tenotomy, autologous whole blood injections, and prolotherapy, can be utilized for treatment. This study examined the effectiveness of these procedures for pain improvement and ability to return to activity for patients with tendinosis. METHODS: This study involved a chart review of patients 15 years or older who underwent at least one treatment for tendinosis at a sports medicine clinic between January 1, 2014 and April 17, 2019...

BACKGROUND: Achilles tendon tenotomy is an integral part of the Ponseti method, aimed at correcting residual equinus and lack of dorsiflexion after correction of the adductus deformity in clubfoot. Percutaneous tenotomy using a number 15 scalpel blade is considered the gold standard, resulting in excellent results with minimal complications. The use of a large-bore needle to perform Achilles tendon tenotomies has been described in literature, but a large-scale randomized controlled trial is currently lacking...

BACKGROUND: There is growing interest in nonoperative treatment for the management of Achilles tendon ruptures (ATRs). However, nonoperative treatment is limited by the risk of tendon reruptures and low satisfaction rates. Recently, atelocollagen injections have been reported to have beneficial effects on tendon healing. PURPOSE: To evaluate the beneficial effects of injected atelocollagen on Achilles tendon healing and investigate the mechanism of atelocollagen on tendon healing...

Sagittal lesser toe deformities (LTD) are the most common in cavus foot. They are mainly the result of muscular imbalance between intrinsic and extrinsic muscles. Surgery is the second-line treatment if medical treatment fails. The aim of the present study was to provide an update on classification and surgical management of LTD in cavus foot including percutaneous procedures with a special focus on sagittal deformities. Joint sparing procedures are preferred for reducible LTD, whereas lesser toe fusions are used for rigid one in association with tendon transfer or percutaneous procedures depending of surgeon's experience and patient's clinical examination...

INTRODUCTION: Diabetic foot ulcers (DFUs) reflect a pivotal event that could lead to serious complications such as amputation and death. Although conservative surgery was reported to have better outcomes when compared to nonsurgical standard of care of forefoot wounds, the surgical management of diabetic toe ulcers (DTUs) is hardly researched. METHODS: The aim of this study is to describe the types and techniques of surgical procedures that could be needed when managing DTU...

Adduction and internal rotation of the shoulder is a common presentation in post-stroke patients, and can often be caused by spasticity and musculotendinous retraction causing a contracture of the pectoralis major and minor muscles. A post cerebral arteriovenous malfunction rupture patient with severe refractory left shoulder spasticity with contracture was treated with cryoneurolysis to the medial and lateral pectoral nerves, combined with a percutaneous needle tenotomy to the pectoralis major tendon. There was an improvement in shoulder forward flexion, abduction and external rotation immediately and found sustained at 8 weeks by 50°, 45°, and 15°...

BACKGROUND: Upper lateral hip pain is a common complaint in adults and is referred to as greater trochanteric pain syndrome (GTPS) and is more prevalent among older women. This is a debilitating condition that could result in lower physical activity and quality of life, and higher unemployment rate. GTPS is a clinical diagnosis, and many cases improve with conservative medical management (CMM). However, there is still a gap between patients not responding to CMM and those who are not good surgical candidates...

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BACKGROUND: Flexor hallucis longus (FHL) transfer is a well-established method for treating chronic Achilles tendon ruptures and tendinopathy. Harvesting of the FHL tendon in zone 2 results in greater length but is also associated with an increased risk of injury to the medial plantar nerve and requires an additional plantar incision. Because of the anatomic proximity of the FHL tendon to the tibial neurovascular bundle in zone 2, the purpose of this study was to investigate the risk of vascular or nerve injury with arthroscopic assisted percutaneous tenotomy in zone 2 of the FHL tendon...

The Achilles is a commonly injured tendon, prone to degeneration and tear. Achilles tendon treatment ranges from conservative management to injections, tenotomy, open versus percutaneous tendon repair, graft reconstruction, and flexor hallucis longus transfer. Interpreting postoperative imaging of the Achilles tendon is a difficult task for many providers. This article clarifies these issues by presenting the imaging findings following standard treatments and depicts expected appearance versus recurrent tear and other complications...

Tenotomy is the final step in the corrective phase for the resolution of residual equinus in the Ponseti method of treating clubfoot. There are several methods for obtaining a complete section of the tendon, ranging from mini-open techniques to percutaneous with a scalpel or percutaneous with a large-gauge needle. Since April 2022, Vittore Buzzi Children's Hospital has performed 36 percutaneous tenotomies of the Achilles tendon in 24 patients using the percutaneous large-gauge needle technique. When compared to the traditional percutaneous scalpel tenotomy procedure, the use of this procedure has allowed us to reduce operating room time, where we routinely perform this type of surgery to optimize pain control and patient safety during the procedure...

Aim: To evaluate the clinical response to augmenting ultrasound-guided tenotomy (USGT) with an amniotic membrane (AM) allograft injection. Design: Retrospective study. Materials & methods: Subjects underwent either a USGT (N = 16) or a combined USGT plus AM injection (N = 14). Results: Both groups demonstrated a significant reduction in pain from baseline starting after 2 weeks in the USGT plus AM group (p = 0.036) and after 8 weeks in the USGT group (p = 0.021)...