Treatment of recalcitrant tendinopathy remains a clinical challenge for physicians without a minimally invasive treatment option that can consistently provide patients with a long-term relief from chronic pain and ability to return to function.

Surgical debridement of degenerative tendon tissue has long been the standard of care to treat degenerative tendon pathology once all conservative or minimally invasive treatment options have failed.

Ultrasound guided tenotomy is an emerging treatment option with the potential to address the underlying degenerative, diseased tissue, by selectively resecting and removing the tissue in a minimally invasive manner. Additionally, with the availability of in-office diagnostic ultrasound imaging, physicians now have an opportunity to evaluate and classify underlying tendon pathology during a clinical exam. This study is to evaluate outcomes in patients presenting with a clinical history of recalcitrant tendinopathy with confirmed diagnosis of degenerative tendinosis using diagnostic ultrasound imaging or MRI.

Inclusion Criteria:

• Patient is 18 - 70 years of age
• Chronic tendon pain ≥ 3 months duration
• History and clinical examination consistent with tendinosis
• Sonographic or MRI confirmation of tendinosis
• 3 months of conservative treatment
• Patient is willing and able to provide informed consent and comply with the study protocol

Exclusion Criteria:

• Full thickness tear of the tendon
• Unable to withhold anticoagulants 7 days prior to the procedure.
• Use above 81mg/day of acetylsalicyclic acid (ASA) and/or non-steroidal anti-inflammatory drug (NSAID) within 7 days of treatment
• Steroid, PRP, Stem cell or biologic injections within 3 months of the study procedure date
• Needle tenotomy, Tenex, or surgical interventions within 6 months of study procedure date
• Active local or systemic infection requiring antiviral, antibacterial or antifungal treatment
• Chronic conditions such as CRPS or fibromyalgia that might affect pain symptoms.

Patients between 18-70 years old presenting with chronic, refractory lateral and medial elbow, hip, or shoulder pain, secondary to tendinosis.