Dr. Paul Goldhagen demonstrates, with the assistance of Dr. Robert Ribolini, how the procedure is performed. In his left hand, Goldhagen holds an ultrasound scanner that shows the inside of the elbow. In his right hand, he holds the small Tenex needle device, which is used to remove diseased tissue. | Austin Nelson

Archived Story

Cutting down recovery time

Published 12:09pm Wednesday, February 6, 2013

New tool bridges gap between surgical, non-surgical procedures

Tennis elbow – a painful condition that affects more than just tennis players – can be a debilitating ailment.

The above device is inserted into the problem area and used to emulsify and remove diseased tissue. | Austin Nelson

But for many, the standard course of treatment – rest, anti-inflammatory medicines and injections – doesn’t stop the pain. In the past, the solution for these patients was surgery.

Thanks to a new procedure that is now being offered at Russell Medical Center, many of these patients might never have to go under the knife to end the pain.

“Tennis elbow is basically tendonitis that involves the outer aspect of the elbow,” said Dr. Paul Goldhagen, orthopedic surgeon and chief of the department of surgery at Russell Medical Center. “Lots of people develop this condition, especially people that do a lot of manual labor and lifting.”

The hospital recently acquired its own Tenex Tissue Removal System – a minimally invasive device that allows Goldhagen to treat patients with tennis elbow, plantar fasciitis and tendonitis of the Achilles without open surgery and with a shorter recovery time. Goldhagen said that he did a series of trials with the machine since last year before the hospital decided that it would be of great use to its patients.

“The whole theory behind minimally invasive surgery is that we are not damaging normal tissue to get to (the diseased tissue),” Goldhagen said.

Using an ultrasound machine, Goldhagen is able to get a clear view of both healthy and diseased tissue. A small hollow needle, which has suction capabilities, is inserted and used to zap bad tissue and remove it.

“Basically this procedure is a way of identifying the diseased tissue, emulsifying it and removing it though a little incision that doesn’t even requires stitches – we put an adhesive bandage on it,” Goldhagen said.

The procedure takes very little time, Goldhagen said. Patients are put under intravenous sedation but are not put under general anesthesia. A local anesthesia is applied to numb the incision site.

The recovery time is about six weeks, Goldhagen said, as opposed to three months or more for open surgery.

While the procedure is relatively new, it isn’t considered an experimental treatment.

“Insurance pays for this,” Goldhagen said. “It has gone through all the proper approval and tests.”

The results so far have been positive. Goldhagen has treated nine tennis elbow patients, and all but one recovered without physical therapy – which is sometimes required. Half a dozen plantar fasciitis patients have been relieved of tendon pain using this device, and Goldhagen said his Achilles tendonitis patients have been reporting recovery times of two to three weeks.

“This is a bridge between non-operative management and open surgery,” Goldhagen said. “It is still not necessarily the first thing we would try any time we see patients with these conditions. But if (early methods fail) then it is time to try this. After that, you have to start looking at surgical options.”

Goldhagen said that he is glad to have these capabilities now at RMC.

“I am really excited that we are able to offer and provide this for patients here,” Goldhagen said. “It is just another way of helping someone get better and getting them back to their sport or work.”