Dr. Mark Jones is a podiatrist with the Methodist Physician Group who has offices in Highland and Merrillville. He specializes in foot-and-ankle reconstructive surgery, podiatric orthopedics, podiatric medicine, diabetes foot care and limb salvage, and nerve surgery and treatment. Jones is focused on developing personal relationships with his patients while bringing them the latest innovations and treatment options.
Q: What is the difference between tendonitis and tendinosis, and what causes it? A tendon is a flexible band of tissue that connects muscle to the bones in your joints. Tendonitis is inflammation of the tendon, while tendinosis is the thickening of the tendon or small tears in the tendon. If it doesn’t heal properly, it becomes thick and irregular and runs the risk of rupturing.
It can be caused by a variety of factors, including running or other sports, climbing stairs or walking. It can occur through repetitive movements including typing, gripping a tool or even cleaning.
Q: What were treatment options for tendonosis prior to Tenex? Generally the treatment options were limited. Someone with chronic tendon pain would get an MRI or have an ultrasound done, and ultimately they would need surgical intervention if they weren’t responding to other forms of treatment. Previously, the doctor would have to make an incision along the tendon, go to where the problem with the tendon had occurred, debride and remove the diseased part, sew up the tendon and then close the patient up.
Q: How is the Tenex procedure different? With the Tenex system, the patient is under local anesthesia or twilight anesthesia. There is a minimal incision. You use an ultrasonic guiding system to place the probe, which means we can target the diseased tissue with the probe, which is the size of a small needle or toothpick.
Once you make the little incision and the Tenex goes in, you push the button on a foot pedal and it takes between 45 and 90 seconds. It can debride the tendon down to a more normal thickness, and it restarts the inflammatory process, which stimulates the body to heal naturally.
And with the minimal incision, patients usually need a single stitch or no stitches. The whole process takes 10 to 20 minutes. The patient wakes up with a wrap on the area and they go home.
Q: Who qualifies for the Tenex procedure? The Tenex procedure is good for someone who has had chronic tendon pain or tendinosis, someone who has been suffering for three months or more.
It is for someone who has not responded to treatment including physical therapy, stretching, anti-inflammatory medications or off-loading treatments, which include a brace, boot or cast.
I am doing these procedures on people who have problems with the tendons in their foot, which would primarily be the Achilles tendon or even plantar fasciitis.
Q: How often do you do this procedure? Are there other applications? We have been doing this here at Methodist for about a year, and have had great success. Right now, it has become pretty routine. They have the quick procedure and then about six weeks of recovery before they can resume their normal activities.
Doctors are looking at using it for other tendon injuries, like shoulder or knee pain, or things like tennis elbow.