Focused Ultrasound Therapy
Focused ultrasound is a rapidly evolving, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with tendon contractures. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.
How it Works
Where the beams converge, focused ultrasound can make small lesions in the tendons, either by thermal ablation or by mechanical methods. When these lesions heal, there is evidence that there is improvement in the tendon function. While significant preclinical work on this is being accomplished, there is still much to be done before this technology will be widely available.
The primary options for treatment of tendon contractures include medication and surgery.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary.
At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of tendon contractures.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for tendon contractures is not yet approved by regulatory bodies or covered by medical insurance companies.
See here for a list of laboratory research sites.
Smallcomb M, Simon JC. High intensity focused ultrasound atomization and erosion in healthy and tendinopathic tendons. Phys Med Biol. 2023 Jan 5;68(2). doi: 10.1088/1361-6560/aca9b7.
Smallcomb M, Elliott J, Khandare S, Butt AA, Vidt ME, Simon JC. Focused ultrasound mechanical disruption of ex vivo rat tendon. IEEE Trans Ultrason Ferroelectr Freq Control. 2021 Apr 23;PP. doi: 10.1109/TUFFC.2021.3075375.
Khandare S, Smallcomb M, Klein B, Geary C, Simon JC, Vidt ME. Comparison between dry needling and focused ultrasound on the mechanical properties of the rat Achilles tendon: A pilot study. J Biomech. 2021 Mar 15;120:110384. doi: 10.1016/j.jbiomech.2021.110384.
Hazlewood D, Feng Y, Lu Q, Wang J, Yang X. Treatment of post-traumatic joint contracture in a rabbit model using pulsed, high intensity laser and ultrasound. Phys Med Biol. 2018 Oct 16;63(20):205009. doi: 10.1088/1361-6560/aadff0.
Gellhorn AC, Gillenwater C, Mourad PD. Intense focused ultrasound stimulation of the rotator cuff: evaluation of the source of pain in rotator cuff tears and tendinopathy. Ultrasound Med Biol. 2015 Sep;41(9):2412-9. doi: 10.1016/j.ultrasmedbio.2015.05.005. Epub 2015 Jun 6.
Muratore R, Akabas T, Muratore IB. High-intensity focused ultrasound ablation of ex vivo bovine achilles tendon. Ultrasound Med Biol. 2008 Dec;34(12):2043-50. doi: 10.1016/j.ultrasmedbio.2008.05.006. Epub 2008 Aug 9.
Click here for additional references from PubMed.