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According to Dr. Noyes, the Tenex procedure is now offered as a first- line treatment, even before cortisone injection therapy. "It's minimally invasive; only a small nick in the skin is required. It's low risk, and only local anesthetic is needed. We've found it to be very effective in our patients," he says. The Tenex procedure involves a diagnos- tic ultrasound of the elbow to identify the area of tendonosis. Under local anesthetic, a tiny (3mm) incision is made, through which the Tenex patented probe — the size of a 16-gauge needle — is guided via ultrasound to the diseased area of the tendon. Ultrasonic energy is emitted through the probe to debride and emulsify the diseased tissue, which is then aspirated via the probe. The surrounding healthy tissue is left undisturbed during treatment. "There's no heat and no cauterizing. It doesn't harm normal tissue," Dr. Noyes explains. "And it's very fast. Actual treat- ment time lasts between 60 and 120 seconds. Afterwards, most of my patients drive themselves home." The incision is so small that no sutures are required. Instead, a dressing comprised of a steristrip and a 4-by-4 placed over the incision is all that's needed. Pain is minimal, so only aspirin — not narcot- ics — is prescribed. Recovery occurs in two to six weeks. "The patient is told not to do anything repetitive with that arm and not to lift anything heavy or use that arm for weight bearing for two weeks," says Dr. Noyes. "In three weeks, after a post-op visit, acclimation to a normal daily routine can begin. At six weeks, the patient can do pretty much anything — including playing tennis, if that's his or her norm." The Benefits According to Dr. Noyes, the Tenex proce- dure offers less morbidity than arthroscopic and traditional open surgery based on the incision and dissection involved. Other advantages of the Tenex procedure include: + less risk of infection + less risk of damage to surrounding healthy structures + shorter recovery time + no need for physical therapy + less scar tissue While general anesthesia is required with arthroscopic and open procedures, it's not with the Tenex procedure. As a result, no 'clearance' is required; neither is an operat- ing room. Instead, the Tenex procedure is performed in a special procedure room at Union Hospital. "Union Hospital has been very supportive of this new technology, and patients have benefitted from it immensely. They are amazed with the results," says Dr. Noyes. He welcomes any physician inter- ested in learning more about the Tenex procedure to come and observe it. A 40-second animated video is also avail- able on East Ohio Orthopaedics' website (see below for website address). Along with Dr. Noyes, East Ohio Orthopaedics includes Drs. Scott F. Holder, Darrin J. Kuczynski, Thomas L. Teater and James E. McQuillan. The growing practice recently moved to new and larger office space in the Heritage Square Plaza in Dover to better meet the needs of patients. For more information, visit www.east ohioorthopaedics.com. To refer a patient, call 330-343-3335. ■ Matthew Noyes is one of a few orthopaedic surgeons between Cleveland and Columbus who currently perform the Tenex procedure for elbow pain. Here he displays the Tenex Health TX probe. Through this patented probe, which is inserted through a 3mm incision into the tendon, ultrasonic energy is emitted and diseased tissue is removed without harming healthy tissue. 2 0 1 4 M AY/J U N E ■ M D N E W S . CO M ■ MD NEWS Cleveland/Akron/Canton | 1 9