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Sports Medicine
Dr. Wisler Saint-Vil, a sports medicine physician with Memorial Health System, joins us to discuss a new development in sports medicine that eliminates chronic tendon pain without invasive surgery- the Tenex Procedure.
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Learn more about Wisler Saint-Vil, MD
Wisler Saint-Vil, MD
Wisler Saint-Vil, MD is a Sports Medicine Physician.Learn more about Wisler Saint-Vil, MD
Transcription:
Sports Medicine
Joey Wahler: There's now a method that eliminates chronic tendon pain without the need for conventional surgery. So we're discussing the Tenex procedure.
Intro: The Memorial Health System is proud to feature our doctors and staff in this important podcast series. It's Memorial Health Radio.
Joey Wahler: This is Memorial Health Radio, a podcast from Memorial Health System. Thanks for listening. I'm Joey Wahler. Our guest. Dr. Wisler Saint-Vil, a sports medicine physician with Memorial Health System. Dr. Saint-Vil, thanks for joining us.
Dr. Wisler Saint-Vil: Thanks for having me
Joey Wahler: Our pleasure. So first, what types of injuries and parts of the body does this Tenex procedure address?
Dr. Wisler Saint-Vil: The Tenex procedure basically addresses any kind of tendon disorders, but mostly chronic tendon disorders, like what we will call a tendonosis. And also, the Tenex procedure also addresses what we will call plantar fasciitis, which is a thickness of the planter fascia. The Tenex is part of a large group of procedures called percutaneous needle tenotomy and the Tenex is a technology that we use to perform the percutaneous needle tenotomy. Other technology that we use is the TenJet. They both basically do the same thing. We go and try to debride the scar tissue from the tendon.
Joey Wahler: And so you mentioned plantar faciitis, which affects the foot and can be very debilitating for people, but what other parts of the body get injured and are treated by this procedure?
Dr. Wisler Saint-Vil: Yes. Other parts of the body that we treat very well with this procedure is the lateral epicondylitis, also named common extensor tendinopathy. The other name that everyone knows is tennis elbow. When someone has a tennis elbow and then they have some scar tissue in the common extensor tendon, we go and do a small incision and, with the percutaneous needle tenotomy, we debride the tendon to allow the tendon to be able to stretch well again.
There's other tendon disorders that we also treat with that like a golfer's elbow. Would it occur, tendinopathy made use tendon, which is in the later aspect of the hip. We can also use this kind of procedure to treat the tendons abnormalities.
Joey Wahler: So, what typical symptoms mean you may need this procedure and should see a doctor?
Dr. Wisler Saint-Vil: The typical symptoms that you will have, basically, it will depend on where you have the issue. For example, if you have plantar fasciitis, you will have lots of pain, mostly with the first steps in the morning. And the first few step in the morning, the pain will be excruciating and you can even diagnose yourself, that is plantar fasciitis. And most of the time, the pain will not get better with over-the-corner pain medications, like NSAID, Tylenols. And for lateral elbow, like the tennis elbow, patient will have pain in the lateral side of the elbow. And most of the time, they won't get better with pain medication. It will be even difficult for them to hold a cup of coffee and any movement that involve the elbow range of motion will be extremely painful. And at that point, they can come and see us. And in the office, we can make the diagnosis with a good physical exam. And also, we can do a diagnostic ultrasound where we can see the scar tissue in the tendon and then we can treat them with the procedure.
Joey Wahler: And speaking of which, doc, talk to us about exactly what the Tenex procedure does to that scar tissue that makes it so effective. What's happening there?
Dr. Wisler Saint-Vil: As I said, the Tenex is one of those technology where we do the percutaneous needle tenotomy. So, the percutaneous needle tenotomy procedure, to understand better, is to explain what the percutaneous needle tenotomy does. The percutaneous needle tenotomy, as the name says, percutaneous means through the skin. We just do a small incision and take the needle through the tendon. And what we do, as I said, what happens with tendonosis or tendinopathy, the scar tissue builds into the tendon. That prevents the tendon to stretch the way it's supposed to be. The tendon is the part of the muscle that's connected to the bone. And that's the part of the muscle that allows the muscle to stretch. When you need to do any kind of movement, the tendon must be ready to stretch, so you can do the movement. When the scar tissue builds in tendon because of chronic inflammation, so that tissue makes the tendon become thick. So, the thickness of the tendon prevent it to stretch. Well, we go and debride tendon from the scar tissue through the percutaneous needle tenotomy. And with that, we are able to remove all the scar tissue and tendon can be able to stretch again. And you can perform those movement that involve that tendon that was affected without any issue.
Joey Wahler: Gotcha. And by the way, I love the quick anatomy refresher course that you gave us there as well. I know I for one can sometimes use it. So because there's just a small incision made, as you said, there are no stitches, right? So how relieved are patients knowing that that's how that works?
Dr. Wisler Saint-Vil: Oh, yeah, my patients or any patient likes that because it is a very minimally invasive procedure when you compare that to the traditional surgical procedure where you will end up with a large incision and that will take days to heal, even weeks. So, the patient will really, really enjoy that, because of the small incision. And the after a week, it is even difficult to see where the incision was. They really like that.
Joey Wahler: Then along those lines as well, this is done on an outpatient basis, right? So you can go home shortly afterward.
Dr. Wisler Saint-Vil: Yes. So that is an elective procedure. Some providers do it in the office, some of them do it in the OR. But whatever you choose, you will be able to go back home the same day without any need to stay in the hospital.
Joey Wahler: Now, despite that good news, there still is, of course, a recovery period. So what does that entail?
Dr. Wisler Saint-Vil: Yes. The good news also is the recovery time from percutaneous needle tenotomy, either you choose to get Tenex or TenJet, will be not close to when you compare it to a additional surgery. It will be basically a six-week period. During those six weeks, after one week, depends on the kind of work you do, after a few days, you can go back to work without any issues at all. The only restriction you will have is to not lift anything heavier than five pounds for six weeks. Other than that, that will depend on which procedure that we did. For the restriction I just said is for the tennis elbow or medial epicondylitis or golfer's elbow.
As for plantar faciitis, they will be in a boot for a week. And after that, they will be good to ambulate without the boot, without any restriction. So, as for the shoulder, when we do a percutaneous needle tenotomy to the rotator cuff tendon, it'll be the same restriction as for the tennis elbow, no more than five pounds for six weeks. And after that, they can lift anything they want to lift or heavier stuff.
Joey Wahler: And so once patients have gotten to that point, doctor, shortly thereafter, with all of this behind them, what would you say are the main differences and benefits that they'll experience?
Dr. Wisler Saint-Vil: The benefit will be the patient is without pain that's the most important benefit because, first of all, we do the procedure to improve the patient's quality of life so they can perform their daily activities and being pain-free. No procedure is 100% that you will say for sure that that will work for you. In the case of percutaneous needle tenotomy, it works for 84% of people. When you compare that with other surgical procedure, it's still a great number. And some of my patients, even after a week, they are completely pain-free, completely pain-free. And they felt very grateful for that procedure and go and talk and talk to all the people about that procedure.
Joey Wahler: Wow, that sounds like a great result. Eighty-four percent success rate is a great number in just about anything in life, right?
Dr. Wisler Saint-Vil: Yes. Yes. That's exactly what my patient will say all the time.
Joey Wahler: Well, folks, we trust you are now more familiar with the Tenex procedure. Dr. Wisler Saint-Vil, thanks so much.
Dr. Wisler Saint-Vil: You're welcome. Thanks for having me.
Joey Wahler: And folks for more information, please visit mhsystem.org/sportsmedicine. Again, that's mhsystem.org/sportsmedicine. If you found this podcast helpful, please share it on your social media. And thanks again for listening to Memorial Health Radio, a podcast from Memorial Health System. Hoping your health is good health, I'm Joey Wahler.
Sports Medicine
Joey Wahler: There's now a method that eliminates chronic tendon pain without the need for conventional surgery. So we're discussing the Tenex procedure.
Intro: The Memorial Health System is proud to feature our doctors and staff in this important podcast series. It's Memorial Health Radio.
Joey Wahler: This is Memorial Health Radio, a podcast from Memorial Health System. Thanks for listening. I'm Joey Wahler. Our guest. Dr. Wisler Saint-Vil, a sports medicine physician with Memorial Health System. Dr. Saint-Vil, thanks for joining us.
Dr. Wisler Saint-Vil: Thanks for having me
Joey Wahler: Our pleasure. So first, what types of injuries and parts of the body does this Tenex procedure address?
Dr. Wisler Saint-Vil: The Tenex procedure basically addresses any kind of tendon disorders, but mostly chronic tendon disorders, like what we will call a tendonosis. And also, the Tenex procedure also addresses what we will call plantar fasciitis, which is a thickness of the planter fascia. The Tenex is part of a large group of procedures called percutaneous needle tenotomy and the Tenex is a technology that we use to perform the percutaneous needle tenotomy. Other technology that we use is the TenJet. They both basically do the same thing. We go and try to debride the scar tissue from the tendon.
Joey Wahler: And so you mentioned plantar faciitis, which affects the foot and can be very debilitating for people, but what other parts of the body get injured and are treated by this procedure?
Dr. Wisler Saint-Vil: Yes. Other parts of the body that we treat very well with this procedure is the lateral epicondylitis, also named common extensor tendinopathy. The other name that everyone knows is tennis elbow. When someone has a tennis elbow and then they have some scar tissue in the common extensor tendon, we go and do a small incision and, with the percutaneous needle tenotomy, we debride the tendon to allow the tendon to be able to stretch well again.
There's other tendon disorders that we also treat with that like a golfer's elbow. Would it occur, tendinopathy made use tendon, which is in the later aspect of the hip. We can also use this kind of procedure to treat the tendons abnormalities.
Joey Wahler: So, what typical symptoms mean you may need this procedure and should see a doctor?
Dr. Wisler Saint-Vil: The typical symptoms that you will have, basically, it will depend on where you have the issue. For example, if you have plantar fasciitis, you will have lots of pain, mostly with the first steps in the morning. And the first few step in the morning, the pain will be excruciating and you can even diagnose yourself, that is plantar fasciitis. And most of the time, the pain will not get better with over-the-corner pain medications, like NSAID, Tylenols. And for lateral elbow, like the tennis elbow, patient will have pain in the lateral side of the elbow. And most of the time, they won't get better with pain medication. It will be even difficult for them to hold a cup of coffee and any movement that involve the elbow range of motion will be extremely painful. And at that point, they can come and see us. And in the office, we can make the diagnosis with a good physical exam. And also, we can do a diagnostic ultrasound where we can see the scar tissue in the tendon and then we can treat them with the procedure.
Joey Wahler: And speaking of which, doc, talk to us about exactly what the Tenex procedure does to that scar tissue that makes it so effective. What's happening there?
Dr. Wisler Saint-Vil: As I said, the Tenex is one of those technology where we do the percutaneous needle tenotomy. So, the percutaneous needle tenotomy procedure, to understand better, is to explain what the percutaneous needle tenotomy does. The percutaneous needle tenotomy, as the name says, percutaneous means through the skin. We just do a small incision and take the needle through the tendon. And what we do, as I said, what happens with tendonosis or tendinopathy, the scar tissue builds into the tendon. That prevents the tendon to stretch the way it's supposed to be. The tendon is the part of the muscle that's connected to the bone. And that's the part of the muscle that allows the muscle to stretch. When you need to do any kind of movement, the tendon must be ready to stretch, so you can do the movement. When the scar tissue builds in tendon because of chronic inflammation, so that tissue makes the tendon become thick. So, the thickness of the tendon prevent it to stretch. Well, we go and debride tendon from the scar tissue through the percutaneous needle tenotomy. And with that, we are able to remove all the scar tissue and tendon can be able to stretch again. And you can perform those movement that involve that tendon that was affected without any issue.
Joey Wahler: Gotcha. And by the way, I love the quick anatomy refresher course that you gave us there as well. I know I for one can sometimes use it. So because there's just a small incision made, as you said, there are no stitches, right? So how relieved are patients knowing that that's how that works?
Dr. Wisler Saint-Vil: Oh, yeah, my patients or any patient likes that because it is a very minimally invasive procedure when you compare that to the traditional surgical procedure where you will end up with a large incision and that will take days to heal, even weeks. So, the patient will really, really enjoy that, because of the small incision. And the after a week, it is even difficult to see where the incision was. They really like that.
Joey Wahler: Then along those lines as well, this is done on an outpatient basis, right? So you can go home shortly afterward.
Dr. Wisler Saint-Vil: Yes. So that is an elective procedure. Some providers do it in the office, some of them do it in the OR. But whatever you choose, you will be able to go back home the same day without any need to stay in the hospital.
Joey Wahler: Now, despite that good news, there still is, of course, a recovery period. So what does that entail?
Dr. Wisler Saint-Vil: Yes. The good news also is the recovery time from percutaneous needle tenotomy, either you choose to get Tenex or TenJet, will be not close to when you compare it to a additional surgery. It will be basically a six-week period. During those six weeks, after one week, depends on the kind of work you do, after a few days, you can go back to work without any issues at all. The only restriction you will have is to not lift anything heavier than five pounds for six weeks. Other than that, that will depend on which procedure that we did. For the restriction I just said is for the tennis elbow or medial epicondylitis or golfer's elbow.
As for plantar faciitis, they will be in a boot for a week. And after that, they will be good to ambulate without the boot, without any restriction. So, as for the shoulder, when we do a percutaneous needle tenotomy to the rotator cuff tendon, it'll be the same restriction as for the tennis elbow, no more than five pounds for six weeks. And after that, they can lift anything they want to lift or heavier stuff.
Joey Wahler: And so once patients have gotten to that point, doctor, shortly thereafter, with all of this behind them, what would you say are the main differences and benefits that they'll experience?
Dr. Wisler Saint-Vil: The benefit will be the patient is without pain that's the most important benefit because, first of all, we do the procedure to improve the patient's quality of life so they can perform their daily activities and being pain-free. No procedure is 100% that you will say for sure that that will work for you. In the case of percutaneous needle tenotomy, it works for 84% of people. When you compare that with other surgical procedure, it's still a great number. And some of my patients, even after a week, they are completely pain-free, completely pain-free. And they felt very grateful for that procedure and go and talk and talk to all the people about that procedure.
Joey Wahler: Wow, that sounds like a great result. Eighty-four percent success rate is a great number in just about anything in life, right?
Dr. Wisler Saint-Vil: Yes. Yes. That's exactly what my patient will say all the time.
Joey Wahler: Well, folks, we trust you are now more familiar with the Tenex procedure. Dr. Wisler Saint-Vil, thanks so much.
Dr. Wisler Saint-Vil: You're welcome. Thanks for having me.
Joey Wahler: And folks for more information, please visit mhsystem.org/sportsmedicine. Again, that's mhsystem.org/sportsmedicine. If you found this podcast helpful, please share it on your social media. And thanks again for listening to Memorial Health Radio, a podcast from Memorial Health System. Hoping your health is good health, I'm Joey Wahler.