Structural and Clinical Outcomes after Tenex Debridement for Rotator Cuff Tendinopathy

Abstract

Rotator cuff tendinopathy (RCT) is a frequently encountered condition by the orthopedic surgeon. Patients presenting with tendinopathy or partial thickness tear present a difficult challenge to treat. Treatments for rotator cuff tendinopathy include nonsurgical and surgical intervention. While surgical management can be effective in the treatment of RCT, patients must be willing to accept risks of anesthesia and surgery and be willing to potentially undergo a lengthy post-operative rehabilitation course. Our study evaluates the use of percutaneous ultrasonic debridement (percutaneous ultrasonic tenotomy (PUT)) of tendinopathy lesions for rotator cuff tendinopathy. This study consisted of 15 patients with symptomatic rotator cuff pathology diagnosed by physical exam and magnetic resonance imaging (MRI). Operative and non-operative treatment options for RCT were discussed with the patients, including the Tenex procedure. The 15 patients who underwent the Tenex procedure were followed post-procedure for clinical improvement with Shoulder Pain and Distability Index (SPADI) scores and for structural improvement with MRI. The present study included 15 patients (16 shoulders) consisting of 8 women and 7 men. The average age of our cohort was 59.9. 14 of the patients achieved improvements in their SPADI (Shoulder Pain and Disability Index) scores and had similar or improved structural appearance on MRI after undergoing percutaneous ultrasonic debridement. The results from this study show that patients with RCT who have tried conservative treatment but are not interested in surgical intervention can consider the Tenex procedure. The procedure carried a high safety profile with significant improvement in outcomes in the majority of patients.