Propel Sports and Orthobiologics
10401 Old Georgetown Road, Suite 104Bethesda, MD 20814
Monday – Friday, 8:00 AM – 5:00 PM
Specialty program
Interventional orthopedics and advanced procedures
Precise, image-guided procedures, including Tenex, tendon scraping, barbotage, and hand releases, for tendon, joint, nerve, and spine problems, performed in the office.
What interventional orthopedics means
Traditional orthopedics often treats a damaged tendon, ligament, or joint in the operating room. Interventional orthopedics treats many of the same problems with image-guided procedures: a needle, a small instrument, or an orthobiologic placed exactly where the injury is, under live ultrasound.
The goal is the least invasive treatment that can work, with a faster return to activity. When surgery is the better answer, we say so and help coordinate it.
What we treat this way
- Chronic tendon pain and small partial tendon tears
- Arthritis of the knee, hip, shoulder, thumb, and hand
- Carpal tunnel syndrome and trigger finger
- Nerve entrapment and nerve pain
- Neck, back, and sacroiliac joint pain
- Calcific tendinitis and exertional compartment syndrome
Advanced procedures under live ultrasound
Ultrasound lets our physicians see the tendon, nerve, or joint they are treating, and the instrument, in real time. That precision makes it possible to work through a tiny opening, steer clear of nearby nerves and vessels, and confirm the target is treated before the procedure ends.
These procedures are for problems that have not settled with rehab and simpler care, such as a tendon that stays painful for months, a calcium deposit in the shoulder, or a nerve or tendon that is being pinched in the hand. We explain when an advanced procedure makes sense and when a surgeon is the better choice.
The tools
Diagnostic and interventional ultrasound, orthobiologics such as PRP, bone marrow aspirate concentrate, and microfragmented adipose tissue, percutaneous tenotomy, hydrodissection, nerve ablation and nerve modulation, and extracorporeal shockwave therapy. Every procedure is paired with a progressive rehab plan.
Advanced and interventional procedures
Explore each option in detail, including who it helps, what to expect, and recovery.
Ultrasound-Guided Joint and Tendon InjectionsOffice-based injections placed under live ultrasound, so the medicine reaches the exact structure that hurts.Percutaneous Tenotomy (Tenex)Removes damaged tendon tissue through a tiny incision so healthy tissue can regenerate. Used for chronic tendinopathy and calcific tendinitis.Ultrasound-Guided Tendon ScrapingFrees a painful tendon from the irritated tissue and small nerves around it, through a needle.Calcific Lavage (Barbotage) for Calcific TendinitisRinses and draws out a calcium deposit in a shoulder tendon through a needle under live ultrasound, often followed by an injection into the bursa.Ultrasound-Guided Carpal Tunnel ReleaseReleases the ligament pressing on the median nerve through a tiny incision under live ultrasound, without open surgery.Ultrasound-Guided Trigger Finger ReleaseReleases the pulley that catches a locking finger, through a needle under ultrasound.Percutaneous Dupuytren's Contracture ReleaseReleases tight cords in the palm through a needle to help the fingers straighten.Capsular Distension (Hydrodilatation) for Frozen ShoulderGently stretches a tight shoulder capsule from the inside with fluid, paired with therapy to restore motion.Ultrasound-Guided Fasciotomy for Exertional Compartment SyndromeRelieves pressure in a tight leg compartment through small incisions guided by ultrasound.Nerve HydrodissectionUses fluid, under ultrasound, to free a nerve that is stuck or compressed by surrounding tissue.Fascia and Scar HydrodissectionLoosens tight or painful scar and connective tissue with precisely placed fluid.Nerve ModulationNerve blocks and stimulators, including peripheral nerve and spinal cord stimulation, that quiet the nerves carrying pain so rehab can move forward.Ultrasound-Guided Nerve AblationUses controlled heat or pulsed energy to quiet the small sensory nerves carrying chronic joint or tendon pain.
Frequently asked questions
- What is interventional orthopedics?
- Interventional orthopedics is the treatment of orthopedic injuries and arthritis with precise, image-guided procedures, such as ultrasound-guided injections, orthobiologics, and minimally invasive releases, rather than open surgery.
- Is interventional orthopedics an alternative to surgery?
- For many tendon, joint, hand, and nerve problems, yes. For others, such as a complete tendon rupture or advanced arthritis with lost function, surgery may be the better choice, and we help coordinate a surgical opinion.
- Are interventional orthopedic procedures done in the office?
- Most are. They are performed under local numbing medicine with ultrasound guidance, and most people go home the same day.
- What makes a procedure advanced?
- We use the term for office procedures that treat the tissue itself, such as removing damaged tendon or releasing a tight ligament, rather than only injecting medicine. They are performed under live ultrasound through a needle or a very small incision.
- Are these procedures done under general anesthesia?
- No. They are done in the office with local numbing, and you go home the same day. Most people walk out wearing a bandage or a brace, depending on the area treated.
- How is Tenex different from tendon scraping?
- Tenex, or percutaneous tenotomy, removes damaged tissue from inside a painful tendon. Tendon scraping frees the tendon from the irritated tissue and small nerves around it. Some tendons benefit from one, the other, or both, and your physician will explain which fits your ultrasound findings.
- What is recovery like after an advanced procedure?
- Recovery depends on the procedure. Hand releases usually allow light use of the hand within days, while tendon procedures are followed by a few weeks of protected activity and a structured rehab plan before returning to sport.
Opening December 1, 2027
Ready to get back in motion?
We are scheduling new patients now. Book an evaluation to find out what is causing your pain and how to treat it.
Bethesda, MD 20814