Through the use of ultrasound, tendons in the body can be visualized very clearly. The Tenex procedure involves making a very small incision (no stitches needed) and inserting a special device that vibrates at the tip. This cuts the unhealthy tendon tissue and removes it through the tip. This leads to a quicker healing time as the body is able to fill in the area with healthier tissue. This procedure can be done for the rotator cuff of the shoulder, plantar fascia of the foot, and etc.

Patients who suffer with chronic pain of their knees, hips, or shoulders, may be candidates for the Coolief Radiofrequency Ablation procedure. This involves using either x-ray or ultrasound to guide specialized needles that use heat at the tip to specifically damage joint sensory nerve branches. These procedures do not affect nerves that provide sensation to the skin, nor does it affect the nerves that control movement or strength.

Dr. Goyeneche uses ultrasound to guide injections or perform procedures through the skin with precision accuracy. Research shows that injections without ultrasound guidance can have very poor accuracy and effectiveness, thus potentially leading to unnecessary surgeries. The use of ultrasound is also leading to a growing number of minimally-invasive procedures, such as Tenex, that can speed healing and reduce complications compared to traditional open surgeries.

Ultrasound also is extremely helpful in guiding simple injections into the target locations more accurately, safely (avoiding surrounding nerves and blood vessels), and less painfully compared to traditional injections. Ultrasound is not only useful for common sites of injection such as the knee and shoulder, but also allows Dr. Goyeneche to inject hundreds of different locations throughout the body, safely and accurately right in the clinic room.

The use of one’s own cells for the healing and regeneration of tissue is an exciting and promising area for not only orthopedic and neurologic conditions, but all of medicine. Especially exciting is the use of cells to treat and reverse osteoarthritis, traditionally an incurable disease. While methods to best extract and use cellular therapies, like stem cells and platelet rich plasma (PRP), continue to evolve, these procedures are exceedingly safe, and showing great promise in terms of efficacy

Dr. Goyeneche trained under Dr. Aaron Karlin, a national leader in concussion management and author of medical textbook chapters on the subject. Dr. Goyeneche teams with Dr. Karlin and several other physiatrists and neurologists within the Ochsner system to form a comprehensive concussion management team. The Ochsner team utilizes the ImPACT test, which is a computerized neuropsychologic measure that helps diagnose and guide return to activity decisions.