Ultrasound-guided probe cures tennis elbow in 15 minutes

SAN ANTONIO (Dec. 12, 2011) — Gloria Rivas, a San Antonio homemaker, protected her right arm in a sling. Brett Hoskins of Houston, owner of a medical company, wouldn’t shake with his right hand. Both came to UT Medicine San Antonio on Dec. 5 seeking relief from the pain of tennis elbow. Now both are pain-free with full range of motion, thanks to a 15-minute minimally invasive procedure. They can resume full activities without restriction by year’s end.

The procedure, called FAST (focused aspiration of scar tissue), is performed in the Ambulatory Surgical Center at the Medical Arts and Research Center, a UT Medicine location. UT Medicine is the clinical practice of the School of Medicine at the UT Health Science Center San Antonio.

FAST uses an ultrasound-guided probe the size of a toothpick to reach the exact area of the elbow where dead tissue is causing pain. “The probe liquefies the bad tissue, runs fluid through it and sucks it out,” said Anil Dutta, M.D., a UT Medicine orthopaedic surgeon whose specialty is the shoulder and elbow.

FAST requires no surgical incision and is inserted through the skin after only local anesthetic with the patient fully awake. A console emits a patented and optimized form of energy to a handpiece with a needlelike tip that specifically breaks up and removes damaged tissue. The aspirated damaged tissue is collected in a bag and the entire device is then discarded.

“It has a very carefully designed energy that gets emitted through the probe. This eliminates diseased tissue without damaging healthy tissue,” said Bernard Morrey, M.D., clinical professor with UT Medicine and chairman emeritus of orthopaedic surgery at the Mayo Clinic. He participated in the development of the device and performed the procedures on Rivas and Hoskins, plus more than 20 other patients worldwide. Because of his stature in orthopaedic medicine, Dr. Morrey was asked to lead a clinical trial that demonstrated FAST’s safety and effectiveness. He is the personal physician to President George H.W. and Barbara Bush.

Rivas and Hoskins reported virtually no discomfort. “I feel like a new woman,” Rivas said. “I had six months of pain and the cortisone shot I had lasted a week. This procedure was no pain. I had no pain.”

Hoskins said: “I had chronic tendonitis from fly fishing. I did ice, ibuprofen, more ice, an injection, in six months another injection – it was chronic and getting worse. Shaking hands was very difficult, as was picking up a suitcase or briefcase. It had a huge effect on my daily activities.”

Of the new procedure, he said: “It was far less painful that a shot in my elbow. During the procedure I felt no pressure or pain. An hour after the procedure, I don’t have the pain I had when I walked in here. It’s completely gone.”

Soon he can return to fly fishing, which “is a really physical sport with heavy rods,” he said. He has enjoyed the hobby in Florida, Idaho and even as far away as southern Chile. “I don’t have a bad hand now,” he said.

“Tennis elbow, like all forms of tendon pain, is an overuse syndrome,” Dr. Morrey said. “It is a very common problem that had no good solution. We needed a way to intervene earlier in patients’ care, to change the nature of the disease and get the people back to work. It has great potential to be a truly cost-effective intervention.”

He added: “There is great interest in the orthopaedic and sports community in this new intervention, in large measure because it appears, to date, to be extremely safe and well tolerated, as well as effective. Without wanting to sound too enthusiastic this early in the process, the results to date are almost unbelievable.”

The therapy, developed by Tenex Health Inc. (www.tenexhealth.com / www.fastprocedure.com), is also being employed with good results to relieve plantar fasciitis of the heel, and pain from the Achilles tendon.

UT Medicine San Antonio is now the center of excellence in the Southwest for the procedure.

UT Medicine San Antonio is the clinical practice of the School of Medicine at the UT Health Science Center at San Antonio. With more than 700 doctors – all faculty from the School of Medicine – UT Medicine is the largest medical practice in Central and South Texas, with expertise in more than 60 different branches of medicine. Primary care doctors and specialists see patients in private practice at UT Medicine’s clinical home, the Medical Arts & Research Center (MARC), located in the South Texas Medical Center at 8300 Floyd Curl Drive, San Antonio 78229. Most major health plans are accepted, and there are clinics and physicians at several local and regional hospitals, including CHRISTUS Santa Rosa, University Hospital and Baptist Medical Center. Call (210) 450-9000 to schedule an appointment, or visit the Web site at www.UTMedicine.org for a complete listing of clinics and phone numbers.

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