What is percutaneous tenotomy/tissue removal of the foot?

Percutaneous tenotomy/tissue removal is a closed surgery. Your doctor doesn't have to make big incisions in your skin to do the surgery. The goal is to relieve tendon pain by removing the damaged tissue. Tendons are strong tissues that connect muscles and bones. Doctors do this procedure to find damaged tendon tissues. Then, they break down the tissue and remove it. 

Doctors often refer to tendon pain as tendonitis or tendinosis. Tendonitis is the inflammation of a tendon. It often causes pain near a joint. Small tears in tissue cause tendinosis. This creates pain and inflammation around the tendon. Either condition can occur at any joint, but feet and ankles are common areas where people need this surgery. Your feet each have more than 100 muscles and tendons, and there are many ways to injure these tendons.

What to expect from percutaneous tenotomy/tissue removal of the foot

Your doctor starts by finding the damaged tendon and tissue using an ultrasound machine to see inside your body. They inject you with a local anesthetic to numb your foot. The doctor makes small cuts near your damaged tendon. They put a small device into one of the cuts. It releases tiny energy waves. That energy breaks the tissue down and removes it, leaving all the healthy tissue behind. The tiny incision doesn't need stitches. You doctor applies a bandage and gives you instructions to keep the area clean and dry. You may need to wrap your foot when you shower.

Some doctors use a needle instead of ultrasonic energy. This helps them get the same results. This treatment is called percutaneous needle tenotomy (PNT). In either case, the tendon grows back over the next few months. Most patients feel better within six weeks. Patients feel close to normal within four to six months. 

Common foot conditions requiring percutaneous tenotomy/tissue removal

If you do an activity over and over, it puts stress on your tendons. Activities that can cause tendon damage include:

  • Golf
  • Skiing
  • Tennis
  • Cleaning
  • Gardening

Some conditions like arthritis can also damage your tendons. Overdoing exercise can also cause tendon pain. Many doctors use this surgery to treat a condition called plantar fasciitis. Plantar fasciitis happens when a large tendon that runs along the bottom of your foot gets swollen and inflamed.

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