TenJet for Chronic Tendinitis

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Tendinitis vs TendinosisWhat Is Tendinitis?What Is Tendinosis?What is TenJet?Video TestimonialsFAQs

Tendinitis vs Tendinosis

Most tendon injuries fall into two categories: Tendinitis and tendinosis

Tendinitis and tendinosis are different types of tendon injury. Although tendinosis is often referred to as chronic tendinitis, understanding which condition is affecting you could impact your treatment and time to resolution, as each requires different treatment approaches.

Tendon injuries can result from a single incident or activities that involve repetitive motion, resulting in micro-tears within the collagen fibers of the tendon.

Healthy Tendon

A healthy tendon is made up of strong, flexible bands of connective tissue that transmit the energy needed to create movement from muscle to bone. Ligaments, such as the plantar fascia, have a similar structure and composition to tendons and can develop injuries similar to tendons.

Tendinitis

Tendinitis refers to an inflamed tendon usually resulting from an acute injury or strain on the tendon. The condition can result in pain and tenderness in the fibrous connective tissue outside of the joint between the muscle and the bone.

Tendinosis

Tendinosis refers to a tendon with a breakdown in its structure and disorganized collagen fibers. At this stage, tendons may retain fluid, develop calcifications, and, if left untreated, develop partial tears or even full-thickness tears with a risk of rupture.

What Is Tendinitis?

Tendinitis is associated with inflammation of the tendon and is not usually associated with tissue degeneration or breakdown of the tendon fibers.

The causes of tendinitis can vary from person to person. In some cases, tendinitis and tendon inflammation may be caused by a sudden injury or strain during activity. In other cases, repetitive motion injuries can lead to chronic tendinitis –sometimes called systemic tendinitis—which may lead some individuals to feel like they keep getting tendinitis or get tendinitis easily.
In many cases, patients experience tendinitis pain in tendons most likely to be injured through repetitive strain or sports injuries. Some of the most common instances include:

  • Plantar Fasciitis in the foot
  • Achilles’ tendon
  • Patella or Quadriceps tendons in the knee
  • Hip tendons such as the gluteus maximus, gluteus minimus, Ilio-tibial band, hamstring
  • Extensor tendon in the elbow (tennis elbow or lateral epicondylitis)
  • Flexor tendon in the elbow (golfers elbow or medial epicondylitis)
  • Biceps tendon in the shoulder
  • Rotator cuff tendons (supraspinatus and/or infraspinatus tendons) in the shoulder

For most patients, tendinitis is diagnosed based on their clinical history and a physical exam performed by a physician. In some cases, other tests, an MRI or ultrasound may be used to confirm that the tendon pain is due to inflammation alone and rule out other causes of pain.
Tendinitis is not permanent. Most tendinitis patients who have inflammation in the tendon should heal within three months with conservative treatments.
Inflammatory tendinitis may heal on its own with rest and ice. Your physician may also recommend bracing, corticosteroid injections, or physical therapy.
Typically, tendinitis is treated by an orthopedic or sports medicine physician. In some cases, a patient may be referred to physical therapy or other allied health specialists if necessary.

 

What Is Tendinosis?

When a tendon is unable to heal or is repeatedly reinjured, the tendon fibers can break down causing loss of structure and loss of strength. This condition is referred to as tendinosis or chronic tendinitis. At this stage, tendons may retain fluid, develop calcifications, have small tears, and, if left untreated, develop partial tears, full-thickness tears, or rupture.

Tendinosis is most commonly caused by the overuse of a damaged tendon during activities related to work or sports without giving the injured tendon time to heal. Tendinosis could also be a result of repetitive strain injury due to weakness or tightness in the muscles connected to the tendons.

Tendinosis pain or chronic tendon pain can be experienced in the same tendons that develop tendinitis, generally in areas where repetitive strain is most likely to cause damage. These can include:

  • Plantar Fasciitis in the foot
  • Achilles’ tendon
  • Patella or Quadriceps tendons in the knee
  • Hip tendons such as the gluteus maximus, gluteus minimus, Ilio-tibial band, hamstring
  • Extensor tendon in the elbow (tennis elbow or chronic lateral epicondylitis)
  • Flexor tendon in the elbow (golfer’s elbow or chronic medial epicondylitis)
  • Biceps tendon in the shoulder
  • Rotator cuff tendons (supraspinatus and/or infraspinatus tendons) in the shoulder

Tendinosis is usually diagnosed by a physician, based on clinical history, a physical examination of the affected area followed by an ultrasound or MRI to confirm the presence of degenerative tissue within the tendon.
Tendinosis is not permanent, and with proper treatment and physical rehabilitation, patients can get back to their pre-injury levels of activity. Time to healing depends on many factors. Studies show that while patients may experience relief from pain in about 3-6 months, with tendinosis healing in around 6-12 months.
Tendinosis is best treated by cutting and removing the diseased tissue, followed by physical therapy and/or home exercises to help the tendon regain its structure and strength. Traditional approaches to accomplish this have been open or arthroscopic surgery. However, tendinosis could also be effectively treated with an ultrasound-guided, minimally invasive procedure using the TenJet resection device.
For most patients, tendinosis can be effectively treated by a physician focused on sports or tendon injuries.

What is TenJet?

TenJet is a needle-like device specifically designed to treat tendinosis or chronic tendinitis and provide relief from chronic tendon pain. The device uses a pressurized, high-velocity jet of saline to selectively resect and remove diseased tendon tissue while sparing healthy tissue.

TenJet enables sports medicine physicians to treat patients suffering from chronic tendon pain due to Tennis Elbow or Golfers’ Elbow, Jumper’s knee, Achilles tendinosis, or tendon calcifications in the shoulder, elbow, hamstring, or hip. It can also be used to treat plantar fasciitis.

The minimally invasive tendon treatment requires only a small incision, is performed in an outpatient setting using real-time ultrasound imaging to visualize the diseased tissue, and aims to accomplish the goal of diseased tissue resection similar to open or arthroscopic surgery.

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Frequently Asked Questions

At the beginning of the procedure, you may feel some discomfort when the physician administers a local anesthetic.  After your treatment, you may feel soreness in the treated area as the anesthetic wears off. 

On average, you should start experiencing improvement in tendon pain as early as 2 weeks after the procedure and continue to experience significant relief within three months of being treated for chronic tendinitis or tendinosis. Your physician will guide your post-treatment recovery plan through physical therapy and/or home exercises. Individual patient results and time to complete symptom relief may vary depending on compliance with post-procedure instructions and other variables. 

When TenJet is used in a minimally invasive procedure, stitches may not needed.

Most insurance companies provide reimbursement for tendon treatment procedures. TenJet may be used by your physician to perform the procedure.