What is tendon fenestration, and how is it performed?
Tendon fenestration is a percutaneous US-guided therapeutic option for the treatment of chronic tendinosis. US is used to target the area of tendinosis. Then, an in plane approach longitudinal to the tendon is used to gently pass a needle through the abnormal portion of the tendon multiple (15 to 30) times. Once the entire abnormal portion of the tendon is felt to be adequately treated and the tendon softens, the needle is withdrawn. The purpose of fenestration is to transform a chronic degenerative process into an acute injury by inducing inflammation and bleeding, which results in local increases in growth factors and other substances associated with healing