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Delivering ultrasonic energy to a target musculoskeletal tissue site includes connecting a delivery device to a vacuum source, a fluid source, and a power signal source. The delivery device has a housing portion maintaining an ultra sound transducer and a tip portion having a sleeve and a cannula. The cannula is coupled to the ultrasound transducer and received in the sleeve to define a covered portion and an exposed portion. Ultrasonic energy is generated by sending a power signal from the power signal source to the ultra sound transducer. The ultrasonic energy is transmitted from the ultrasound transducer to the cannula, such that the exposed portion of the cannula delivers ultrasonic energy at a frequency that is pre-selected to debride musculoskeletal tissue upon percutaneous insertion of the tip portion.