Ultrasound-Guided Treatment Options for Lateral Elbow Tendinopathy

Work Type

Poster

Abstract

Research Question: Are ultrasound-guided tenotomy procedures safe and effective for lateral elbow tendinopathy, both short-term and long-term? Should they be recommended to patients who suffer from lateral elbow tendinopathy more often than currently reported?

Lateral elbow tendinopathy, also known as “tennis elbow,” is a common complaint that is estimated to affect approximately 1 million people in the United States each year. While this condition is thought to be self-limiting, some individuals can have pain affecting daily activities for years before finding relief. The first line treatment options are conservative oral analgesics, physical therapy, activity modifications, bracing, and various injections. As of now, there is no established research demonstrating which conservative measure performs best.

Percutaneous ultrasound-guided tenotomy is a procedure performed using either the TENEX device or the TenJet device. The TENEX device involves phacoemulsification to debride and aspirate diseased tendon tissue using an ultrasonic vibrating double-lumen needle. On the other hand, the TenJet device delivers high-velocity sterile saline with a venturi suction effect at the needle tip, creating a cutting window to hydroresect diseased tendon tissue. The goal of removing diseased tendon tissue is to replicate the benefits of surgical debridement and provide long-term resolution of symptoms.

A similar procedure called percutaneous ultrasound needle tenotomy (PUNT) or percutaneous needle tenotomy (PNT) uses a hypodermic needle to break down scar tissue by repeated needle fenestration. This process is thought to stimulate a localized inflammatory response, promoting tendon healing through increased blood flow, fibroblast activity, and tissue remodeling.

There is no current treatment algorithm for lateral elbow tendinopathy and therefore newer treatment options such as these are not well known by providers and underutilized. Therefore, the goal of my capstone project is to increase provider awareness and understanding of ultrasound-guided tenotomy procedures as safe and effective treatment options for lateral elbow tendinopathy.

Publication Date

5-17-2026

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