Tendon Treatment Center

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A “Tendon Treatment Center” can be established as part of an established orthopedic practice. Ideally, access to a number of modalities, which will be described, will further enhance the value of this center. Conservative care of tendinosis is currently part of clinical practice, and physical therapy is either an in-house service or referred out. MRI or ultrasound studies are diagnostic tools that aid in the location of the pathology as well as in the confirmation of tendinosis. Access to the use of bipolar radiofrequency (bRf) micro-tenotomy (Topaz; ArthroCare, Sunnyvale, CA) is readily available to all orthopedic surgeons. The procedure is done at an ambulatory surgery center. One may choose to lease a low energy extracorporeal shockwave therapy unit (ESWT), or use a high-energy machine that is leased by an ambulatory surgery center or hospital. Once these modalities and services are secured and/or contracted, then the orthopedists may begin to notify colleagues and referral physicians of this “Center.” Full details of the proposed mechanism of action and the science behind bRf microtenotomy and ESWT is described. The economic advantages of each of these treatment modalities are discussed as well.

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