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The downsides are that it’s even more expensive than PRP, it may only be available in major cities and, and, like PRP, it’s typically not covered by insurance (and it can be quite painful – during and for days after the procedure – especially the bone puncture site in your pelvis!) Here’s my article with more on Stem Cell Therapy Minimally-Invasive Surgical Techniques Now, we come to the more advanced forms of Tenotomy that are closer to full surgery but still considered “minimally invasive.” There are two major brands/techniques: Tenex and TenJet , both of which can be done on an outpatient setting under local anesthesia