Tennis elbow or lateral epicondylitis is an overuse injury that causes inflammation of the tendons on the outside (lateral) side of the upper arm near the elbow. A tendon is a band of tissue that connects muscles to bones. Tennis elbow is usually caused by overuse of the forearm muscles and is commonly seen in tennis players, hence the name, especially when poor technique is used when hitting the ball with a backhand stroke. Other activities such as painting, carpentry or plumbing that require repetitive motion of the forearm can also cause tennis elbow.
The signs and symptoms of Tennis Elbow include pain over the outside of the elbow, pain when lifting objects, and a weakened grip. The standard options for treating tennis elbow include rest, anti-inflammatory medications, physical therapy, and surgery. These treatment options can take several months or years for symptoms to improve.
A new treatment option is now available called FAST or “focused aspiration of scar tissue” which is designed to remove the source of pain faster and safer than traditional open surgery.
The pain associated with tennis elbow has always been thought to be from inflammation, but is now believed to be caused by scar tissue deep within the tendon. The FAST procedure is a minimally invasive procedure that removes tendon scar tissue from the elbow and allows you to return to your active lifestyle. In the FAST procedure, the Tenex or TX1 tissue removal system is utilized to deliver ultrasonic energy to a hand piece with a needle like tip that breaks up and removes the damaged tissue.
Tennis elbow should be evaluated by an orthopaedist for proper diagnosis and treatment. Your doctor makes a diagnosis by asking about your pain and examining your elbow.
Your physician may order an x-ray to rule out arthritis as the cause of your pain. An MRI scan may be ordered to rule out other conditions that can cause elbow pain. An electromyography (EMG) may be done to rule out pain caused by pressure on a nerve. An EMG is a technique of recording the electrical activity of muscles.
The FAST procedure uses the TX1 Tissue Removal System which is a portable, self-contained device that offers precise removal of diseased tendon tissue for use in the elbow, knee, ankle, foot and shoulder. The TX1 System removes scar tissue with an ultrasonic aspirator which emulsifies and removes soft tissue.
The system is comprised of a console, ultrasonic hand piece, tube set, and foot pedal to control the functions of the system. The TX1 interface has four modes of operation including irrigation, aspiration, debridement, and coagulation. The TX1 console has a touch-screen interface for selection of settings.
The hand piece kit consists of a TX1 disposable hand piece, tubing, cartridge, single-use antiseptic and applicator, single-use local anesthesia and syringe, 16-guaze dilator, and single use ultrasonic gel.
The goal of the FAST procedure is to remove diseased tissue around the affected joint and alleviate the patient’s symptoms.
This procedure takes about 20 minutes and is usually performed under local anesthesia to numb the area. Ultrasound is used to identify the exact area of the joint where scar tissue is causing pain. A small cut of less than 5 mm is made in the skin at the elbow. After locating the scar tissue, the TX-1 micro tip is inserted into the skin. The computer console delivers ultrasonic energy through the micro tip to break up the scar tissue. A sterile fluid is injected into the area through a saline delivery system housed in the micro tip. A hollow needle also within the micro tip pulls out the fluid along with the emulsified scar tissue. After the scar tissue is removed, the tiny opening is closed with an adhesive bandage.
After the procedure
Following the procedure, you will be allowed to go home. If you experience any discomfort, your doctor will recommend over the counter pain medications. You should avoid any weight-bearing activities for at least 2 weeks after the procedure.
Benefits of Tenex FAST procedure include:
- Faster recovery
- Less pain
- Early return to normal activities
- Requires less surgical time
- Low risk of infection