Tenotomy or Fasciotomy (Fenestration) Therapy

Tenotomy or fasciotomy involves needle fenestration of a tendon, fascia, or other tissue, similar to acupuncture, which encourages your body to stimulate healing. A radiologist will use a small needle to gently treat the torn or inflamed area with the help of image-guided technology. This procedure is used to treat chronic tendon inflammation, local tendon tears, ligament tears, or fascia inflammation.

This procedure can be combined with platelet-rich plasma injections to further strengthen and accelerate healing.

HOW DO I PREPARE FOR MY PROCEDURE?

• You must have an ultrasound of the area of concern prior to your injection to ensure the procedure is safe to perform.
• If you are on anticoagulation drugs (Plavix, Coumadin, Warfarin, etc.) you may need to have an international normalized ratio (INR) test and temporarily stop your medication prior to the procedure. Please inform our booking coordinators so that they can discuss this in more detail with you.
• IMPORTANT: Please schedule your injection either two weeks before or one week after any vaccination appointment.
• If you are currently taking antibiotics, you will need to wait two days after your last dose before having your injection.
• Take all prescribed medications as directed.
• Arrive 15 minutes prior to your appointment.
• Wear comfortable clothing.
• Bring photo identification and your provincial health card.
• Please do not bring children who require supervision.

WHAT HAPPENS DURING MY PROCEDURE?

• We may provide you with a comfortable clinic gown to change into (depending on the area being treated).
• A team member will explain the consent form, procedure details, and answer any questions.
• We will then escort you to our treatment suite where you will meet the radiologist who will clean the skin and inject a local anesthetic, similar to the freezing you get at the dentist.
• Ultrasound will be used to target the area and perform the procedure.
• You will be assessed post-injection by our team and, if there are no concerns, you will be free to leave.

POST-PROCEDURE INSTRUCTIONS

• First 24 hours: Please rest and keep the treatment area clean. Leave the Band-Aid on. Do not shower.
• First 48 hours: Avoid bathtubs, hot tubs, and pools. Avoid strenuous activities and lifting.
• After one week: Avoid any strenuous activity for five days post-injection. A gradual return to activity is advised depending on the underlying issue. Be mindful of your pain and stop if it hurts too much. Although the procedure is gentle, it may temporarily weaken the tendon and put it at risk of rupturing. Notify your physiotherapist that you have had this injection so they can modify your exercises if necessary.
• If possible, please avoid anti-inflammatory medication for two weeks (such as ibuprofen – Advil). It may interfere with the effectiveness of your procedure.
• Watch for infection: If you develop worsening pain, skin redness at the site of injection, or a temperature greater than 38.5°C, please proceed to an urgent care or emergency centre.
• If you have pain or other symptoms beyond 48 hours after your injection, this is a normal reaction. You may apply heat and ice to the treatment area. If you have any questions, please email us at paintherapy@radiology.ca during business hours.
• Anti-coagulant therapy: You will be directed when to resume any anti-coagulant (blood thinners) medication.

WHEN WILL I SEE RESULTS?

• We will arrange a follow-up ultrasound in six months to evaluate how the tendon is healing. Pain may increase for a few days post-injection as the body mounts an inflammatory response, but this should subside.
• Results can vary from weeks to months depending on the body part involved, severity of the disease, and your symptoms. Most patients get complete relief that is permanent while, rarely, others have limited response.
• If an injection does not improve your symptoms, then you may need further evaluation.

HOW MUCH WILL IT COST?

This procedure is covered under your Alberta Health Care Plan. It is not currently offered at our Saskatchewan clinics. If you have the procedure with PRP, there will be an added cost.