ROCHESTER, Minn. — Mayo Clinic doctors recently developed a new approach to treat tennis elbow that may eliminate the need for surgery in some patients who don't respond to conservative therapies. The March issue of Mayo Clinic Health Letter covers this new technique called fasciotomy and surgical tenotomy.
The initial treatment, rest and physical therapy, fails to help about 10 percent of people with tendon pain in the elbow, or tennis elbow. Degenerative scar tissue that often develops in the tendon doesn't improve with rest. For those patients, the next course of treatment has been surgery to remove scar tissue. The procedure could be open surgery that requires cutting through healthy tissue to reach the tendon or via a minimally invasive approach that requires several small incisions. Both surgical techniques require anesthesia and time in the operating room.
With fasciotomy and surgical tenotomy, there are no incisions and no anesthesia, just a numbing agent at the site of the procedure. Doctors use ultrasound imaging to locate scar tissue within a tendon. An instrument resembling a hollow-tipped needle is inserted to the site of the scar tissue. When activated, the device rapidly moves back and forth, breaking up scar tissue with ultrasonic energy. Meanwhile, the treated tissue is suctioned away.
Mayo Clinic doctors report that initial clinical experience has been positive. Since the procedure was introduced more than a year ago, 2,500 of the procedures have been performed worldwide. There have been no major complications, and the procedure appears safe when conducted by skilled hands. However, large-scale effectiveness studies have yet to be published. Several groups are collecting data on the procedure, and results are expected to be published during the next year.
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