Ultrasound-Guided Minimally Invasive Tenotomy Utilizing TenJet for Recalcitrant Gluteal Tendinopathy: A Six-Month Interim Analysis From a Prospective Multicenter Study
Abstract
Background: Chronic gluteal tendinopathy is characterized by failed tendon healing, collagen disorganization, and breakdown in tendon structure. Traditional conservative management involves nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and corticosteroid injections. However, next steps for recalcitrant cases are lacking consensus. The TenJet device (HydroCision, Inc., North Billerica, Massachusetts, United States), utilizing high-pressure saline to resect degenerative tissue, offers a minimally invasive option to treat gluteal tendinopathy. Methods: From 2022 to 2025, 46 patients with gluteal tendinopathy refractory to conservative treatment were enrolled across multiple centers with planned 24-month follow-up. Visual Analog Scale (VAS) pain score and Victorian Institute of Sport Assessment-Gluteal Questionnaire (VISA-G) patient-reported outcomes were prospectively collected via REDCap alongside demographics, treatment history, procedural details, and adverse events. Results: The cohort was predominantly female (44/46, 95.6%), with a mean age of 60.7±8.44 years and a mean BMI of 26.9±4.73 kg/m². The mean VAS improved from 5.81±2.02 at baseline to 3.14±2.24 at two weeks (p<0.001), 2.40±2.00 at six weeks (p<0.001), 2.17±1.87 at three months (p<0.001), and 2.10±2.10 at six months (p<0.001). VISA-G improved from 44.9±14.3 at baseline to 49.0±19.1 at two weeks (p=0.807), 62.2±15.8 at six weeks (p<0.001), 66.9±15.2 at three months (p<0.001), and 69.6±12.6 at six months (p<0.001). One patient developed an adhesive-related rash; no device malfunctions or serious complications were observed. Conclusions: Ultrasound-guided minimally invasive tenotomy with TenJet was associated with significant, sustained reductions in pain and improvements in function through the six-month follow-up, with a favorable short-term safety profile for chronic gluteal tendinopathy refractory to conservative management.