Non-Surgical

Platelets in your blood play an important role in healing because they release growth factors at the injury site. Platelet-rich plasma (PRP) is a concentrated solution of platelets and their associated naturally occurring growth factors. When injected into the injury site, PRP harnesses the body’s natural healing processes to repair and strengthen injured tissues, potentially speeding up recovery and improving function.

A PRP injection involves a blood draw from your arm. A small amount of your blood is collected and spun in a centrifuge machine to separate the platelets and fluid from the other blood cells. This solution undergoes additional processing and ultimately is called platelet-rich plasma. The PRP is injected into the injured area under ultrasound guidance. The activated growth factors stimulate the growth of new blood vessels, reduce inflammation, and release repair cells to accelerate the healing process and provide symptom relief.

Because PRP is made from your blood, it is considered safe. Side effects may include pain at the site of injection and swelling that resolves within a few days. Many patients experience a reduction or elimination of pain and inflammation. PRP is often paired with an individualized physical therapy program.

PRP injections treat sports-related injuries, including tendonitis, ligament sprains, muscle strains, and early osteoarthritis. For certain conditions, PRP therapy has been shown to significantly improve function and quality of life so you can get back to the life you love.

Viscosupplementation is the injection of hyaluronic acid into a joint. Hyaluronic acid is a naturally occurring substance found in the synovial fluid of joints, where it acts as a lubricant. Viscosupplementation is often used to treat knee osteoarthritis, and it may help reduce pain and improve knee function.

Ultrasound-guided injections use ultrasound imaging to precisely guide the delivery of medication directly into specific areas of the body. This approach is commonly utilized in various fields, including pain management, sports medicine, and rheumatology. The use of ultrasound allows for the direct visualization of soft tissues, bones, and needles in real time, which can enhance the accuracy and efficacy of the injection.

The physician applies a water-based gel to the patient’s skin and places the ultrasound probe over the target area, such as a joint or tendon. The ultrasound machine displays real-time images of the underlying structures. Under continuous ultrasound guidance, the physician advances a needle toward the target area. The needle’s progress can be visualized on the ultrasound screen to ensure proper placement. Once the needle is correctly positioned, the therapeutic medication (which could be a steroid, pain reliever, PRP, viscosupplementation, or other medication) is injected into the target area.

The TENEX procedure, or percutaneous tenotomy, is a minimally invasive procedure designed to treat tendinopathy, a painful condition resulting from tendon damage typically due to overuse or chronic wear and tear. Tendinopathy is a broad term used to describe issues with a tendon. Tendinopathy commonly affects the rotator cuff, Achilles tendon, patellar tendon, elbow, and gluteal tendons. More specifically, tendons can be affected by tendonitis, inflammation of the tendon, or tendinosis, which is chronic degeneration without inflammation. TENEX is an FDA-approved procedure that can help treat tendinopathy.

Procedure overview:

• The TENEX procedure begins with diagnostic ultrasound, which visualizes the damaged tendon and identifies the specific location of the degenerated tissue.
• The targeted area is numbed with a local anesthetic to minimize discomfort during the procedure.
• A tiny incision is made, and the TENEX device, which combines ultrasonic energy with aspiration, is inserted into the damaged tendon tissue.
• The ultrasonic energy breaks down and emulsifies the damaged tissue, which is then aspirated out of the body, leaving the healthy tissue intact.
• The incision is so small that stitches are often unnecessary, and the site can be closed with an adhesive bandage.
• Recovery is typically 4-6 weeks, with sport-specific rehabilitation from 6-12 weeks.

The advantages of this procedure include:

• It is minimally invasive, which means only a small incision is needed, which reduces the risk of infection and scarring.
• It is typically an outpatient procedure that takes less than an hour to complete.
• Patients can often return to normal activities within a few weeks, compared to the months of recovery that may be required after traditional open surgery.
• Ultrasound guidance allows for targeted treatment of only the damaged tendon tissue.
• Many patients experience significant pain relief after the procedure.

TENEX was developed at the Mayo Clinic and has been shown to help tendon pain in over 85% of patients.