Getting tendinopathy treatment (and terminology) right

Percutaneous needle tenotomy: Consider it for difficult cases

Percutaneous needle tenotomy is thought to benefit tendinosis by disrupting the tendinotic tissue via needling, while simultaneously causing bleeding and the release of growth factors to aid in healing. Unlike surgical ­tenotomy, the procedure is typically performed with ultrasound guidance in the office or other ambulatory setting. After local anesthesia is administered, a needle is passed multiple times through the entire region of abnormality noted on ultrasound. Generally, around 20 to 30 needle fenestrations are performed.^37,38

Consider prolotherapy for lateral epicondylosis, rotator cuff tendinopathy, and Osgood Schlatter disease.

In one retrospective study evaluating 47 patellar tendons, 81% had excellent or good results.³⁸ In a retrospective study for lateral epicondylosis, 80% had good to excellent results.³⁹

CORRESPONDENCE
Kyle Goerl, MD, CAQSM, Lafene Health Center, 1105 Sunset Avenue, Manhattan, KS, 66502-3761; kvg3355@ksu.edu.