Mayo Clinic Orthopedics and Sports Medicine has a long history of pioneering new procedures for sports injuries. “We always ask two questions before we develop a new procedure: One, can we? Two, should we? And if we can answer yes to both of those questions, we assemble a team,” says Brennan Boettcher, D.O., sports medicine physician, Mayo Clinic Orthopedics and Sports Medicine. That team, which consists of radiologists, orthopedic surgeons, clinical anatomists, and sports medicine physicians, works to identify how best to treat a new problem and come up with a solution that may be viable. That solution may be a minimally invasive treatment, which offers the benefit of smaller incision(s), quicker recovery, faster return to sports or activities, and less risk for complications than traditional, open surgeries. Ultrasound-guided procedures are one type of this.

• Ultrasound diagnostic and procedural expertise
  The Mayo Clinic Orthopedics and Sports Medicine practice is accredited in both diagnostic and interventional ultrasound procedures by the AIUM (American Institute of Ultrasound in Medicine).  Coming to Mayo means knowing that your ultrasound procedures are “being performed by people who really understand how to perform ultrasound-guided procedures, how to make sure they are performed as safely as possible, and that the diagnosis they get from that ultrasound is correct,” says Dr. Boettcher.
• Ultrasound-guided fasciotomy
  For difficult problems such as chronic exertional compartment syndrome (an exercise-induced condition that causes pain, swelling, and sometimes disability in the affected muscles and nerves of the legs or arms), we are now not only able to do extensive testing to identify the cause of the problem, but we have also developed an ultrasound-guided fasciotomy (cutting the fascia to relieve pressure) to treat it in an outpatient procedure.
• Ultrasound-guided trigger finger release
  While Mayo’s hand surgeons still do open trigger finger releases, some of our sports medicine physicians have pioneered, and perform ultrasound-guided procedures to treat trigger finger, as well as a type of wrist tendonitis called De Quervain tenosynovitis. “When we perform these procedures under ultrasound guidance, the complication rate drops to almost nothing. Typically, patients have no scar and minimal pain after the procedure,” says Dr. Boettcher, and patients can return to normal activities in a couple of days. Additionally, since patients are awake during the office-based procedure, results are tested and assessed immediately following it.
• Plantar fasciitis
  Often those dealing with plantar fasciitis have been suffering for years, even after trying orthotics, physical therapy, or cortisone injections. Our sports medicine experts have developed minimally invasive procedures that can reduce or eliminate that pain, with some treatments even showing up to a 90% success rate. The outpatient ultrasound procedure options for this include either a fascia debridement with a specialized device or a platelet rich plasma (PRP) injection.
• Patellar and Achilles tendonitis
  Mayo Clinic Orthopedics and Sports Medicine has innovated new treatment options for patellar and Achilles tendinopathy, including minimally invasive tendon scraping, in which some of the painful nerves are mechanically separated from the tendon. The tendon scraping procedure can reduce the painful signal from small abnormal nerves that grow into the patellar or Achilles tendons. Following this procedure, the majority of patients can return to sports within a week, with much less pain.
• Orthobiologics injections like platelet rich plasma (PRP)
  Mayo Clinic is at the forefront of researching and using orthobiologic injections, like platelet rich plasma (PRP) injections, that use components of the patient’s own body to assist in its healing process. Jacob Sellon, M.D., sports medicine physician and Co-Chair of Mayo Clinic Orthopedics and Sports Medicine explains, “Platelets are the part of the blood that stimulate the healing process.” To get them, we draw a sample of blood from the patient, concentrate the parts of the blood that we want, and then use ultrasound guidance to inject that platelet rich plasma into the area of the body to be treated. The whole process takes place in the office, in less than an hour or so.

Studies have shown PRP offers the potential to delay joint replacement, may help with pain and functioning, and can be used synergistically with standard treatments such as physical therapy to lead to better outcomes. “Mayo Clinic is one of the leaders in providing these orthobiologic injections to individuals,” says Shelby Johnson, M.D., sports medicine physician, Mayo Clinic Orthopedics and Sports Medicine, “and what’s really important about how we use these new injections and procedures is that we’re evidence-based in what we’re doing.”

Extensive thought, resources, and research are put into the development and use of innovative new treatments at Mayo, and after implementing them, our team follows patients’ recovery and tracks outcomes, allowing us to assess and make adjustments, if needed.

Further, coming to one of Mayo Clinic Orthopedics and Sports Medicine specialty clinics for a minimally invasive treatment, such as an ultrasound-guided procedure, means you’re getting a one-stop shop and access to a multidisciplinary team of experts. Consultations, imaging, and treatments are often scheduled for the same day. The whole team works together to come up with the best individual treatment plan for you, which may include meeting with a physical therapist before or after the procedure, to help you return to daily life and activities as soon, and as safely as possible.

For more information, or to make an appointment, please visit sportsmedicine.mayoclinic.org.