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Tenotomy and debridement of diseased tendon can resolve symptoms due to chronic degenerative tendinopathic lesions (i.e. tennis elbow). Recent improvements in musculoskeletal ultrasound imaging and the development of a minimally invasive ultrasound-guided ultrasonic energy debridement tool, the TX1 (Tenex Health, Inc., Lake Forrest, CA), have created a viable less invasive alternative to open tenotomy and debridement procedures. The rationale behind this novel and minimally invasive procedure is to ultrasonographically visualize the diseased portion of the tendon and guide a small ultrasonic-energy debridement tool under dynamic sonographic imaging into the tendinopathic region to complete a percutaneous tenotomy and debridement procedure. The TX1-debridement tool is safe and has demonstrated similar or better outcomes to open tenotomy and debridement procedures.