Percutaneous Tenotomy With Ultrasonic Debridement for Lateral Epicondylitis: Surgical Technique and Short-term Patient Outcomes.

Abstract

Lateral epicondylitis, commonly called "tennis elbow," is a prevalent musculoskeletal disorder affecting individuals engaged in repetitive movements. Nonsurgical treatments often yield temporary relief, but refractory cases require surgical intervention. This study evaluates the efficacy of percutaneous ultrasonic tenotomy (PUT) with the Tenex TX system as a minimally invasive alternative for treating chronic lateral epicondylitis. We conducted a retrospective case series of 20 patients treated between 2017 and 2022, with at least 12 months of follow-up. The procedure involved ultrasound-guided debridement and aspiration of abnormal tissue via a small incision under local anesthesia, with optional digital via VR headset or IV sedation. Pre- and postoperative data were collected to assess pain levels, activity limitations, and patient satisfaction. Results demonstrated significant improvements in pain (P<0.001), strength (P<0.001), and sleep (P<0.05). Patients returned to normal activities within 3 to 7 days and reported a mean satisfaction score of 4.45/5. Notably, 100% indicated willingness to undergo the procedure again if required. Complications were minimal, consistent with existing literature. This study supports PUT as a safe and effective option for managing refractory lateral epicondylitis. Its minimally invasive nature, coupled with rapid recovery and high patient satisfaction, underscores its potential to replace more invasive surgical alternatives. However, further research with larger cohorts and extended follow-ups is warranted to validate long-term outcomes and refine procedural protocols.