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PURPOSE: To evaluate outcomes of radiofrequency coblation for chronic tendinosis of the foot and ankle tendons.
METHODS: Records of 7 men and 8 women (16 feet) aged 27 to 65 years who underwent radiofrequency coblation for chronic tendinosis (combined with other procedures for other pathology) of the Achilles, posterior tibial, and peroneal tendons were retrospectively reviewed. The visual analogue scale (VAS) for pain status, the Short Form (SF-36) questionnaire for quality of life, and the American Orthopaedic Foot and Ankle Society (AOFAS) scores for functional status of the patients were determined pre- and post-operatively.
RESULTS: All patients reported significant reduction in pain at 3 months, with more than 63% attaining VAS scores of 0 at 6 months. AOFAS scores were significantly improved at both 3 and 6 months. Most components of SF-36 scores improved at 6 months except those for general health and role emotional; only those for bodily pain improved significantly. At postoperative month 3 and 6 respectively, 93 and 100% of the patients had their expectations met, whereas 93 and 88% had good-to-excellent satisfaction. There were no major complications.
CONCLUSIONS: Radiofrequency coblation for chronic tendinosis of the foot and ankle achieves good short-term outcomes and pain relief. It may be combined with other procedures for maximal benefit.
Dear All
This paper needs to be placed in the nearest bin!
How can you do a specific treatment then throw in others for other pathology.
why could the 'other pathology' not be the cause of pain?
These studies do nothing for anyone. It would not get past first base in a respected journal.
Re: Radiofrequency coblation (topaz) for chronic foot and ankle tendinosis.
Is Percutaneous Radiofrequency Coblation for Treatment of Achilles Tendinosis Safe and Effective?
Naohiro Shibuya, DPM, MS, FACFAS, Jakob C. Thorud, DPM, MS, Jon M. Humphers, DPM, J. Marshall Devall, DPM, Daniel C. Jupiter, PhD Journal of Foot and Ankle Surgery; Article in Press
Quote:
Insertional Achilles tendinosis results in isolated pain at the Achilles tendon insertion site due to intratendinous degeneration. When conservative measures fail, surgical treatment may be necessary. Radiofrequency coblation has been suggested to be an effective procedure for treatment of tendon pathologies. Percutaneous execution of this procedure is very simple as well as minimally invasive, and thus if effective, would be an excellent alternative to an open treatment of insertional Achilles tendinopathy. A review of 47 cases with this percutaneous technique was conducted. In our relatively short-term follow-up (mean = 8.6 months, SD = 9.71, range 1 to 40), the incidence of reoperation was 14.9% (7/47). Rupture of the Achilles tendon was identified in 3 (6.4%) patients. Our cohort had a relatively high body mass index (mean = 37.1, SD = 6.96, range 24.3 to 52.8). We recommend surgeons to be cautious about selecting this procedure in similar, high body mass index patient cohorts for treatment of Achilles tendinosis.
Re: Radiofrequency coblation (topaz) for chronic foot and ankle tendinosis.
Open technique is more effective than percutaneous technique for TOPAZ radiofrequency coblation for plantar fasciitis.
Tay KS, Ng YC, Singh IR, Chong KW. Foot Ankle Surg. 2012 Dec;18(4):287-92
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Quote:
BACKGROUND:
Microtenotomy coblation using a radiofrequency (RF) probe is a minimally invasive procedure for treating chronic tendinopathy. It has been described for conditions including tennis elbow and rotator cuff tendinitis. There have been no long term studies to show its effectiveness in plantar fasciitis.
METHODS:
A prospective non-randomised trial was conducted on 48 patients who had failed conservative treatment for plantar fasciitis, between 2007 and 2009. The procedure was performed using the TOPAZ microdebrider device (ArthroCare, Sunnyvale, CA), either via an open or a percutaneous method. Fifty-nine feet were treated and followed up for up to 1 year thereafter. Preoperative, 3, 6 and 12 months post-operative VAS pain, American Orthopaedic Foot-Ankle Society (AOFAS) hindfoot and SF-36 scores, patient expectation and satisfaction scores were analysed.
RESULTS:
VAS scores improved significantly in both groups at 1-year follow-up. The open group had a more significant improvement in the VAS score at 1-year follow-up. AOFAS hindfoot scores improve significantly for both groups pre- and post-operatively, but there was no significant difference between both groups at the 1-year mark. SF-36 scores showed equally significant improvement in both groups 1 year post-operatively. Expectation and satisfaction scores were equally high in both arms.
CONCLUSIONS:
TOPAZ RF coblation is a good and effective method for the treatment of recalcitrant plantar fasciitis. Clinical results improve with time for up to 1-year post-operatively. The open method seems to have a more significant improvement in pain VAS scores at 1-year postoperatively.
Radiofrequency coblation (topaz) for chronic foot and ankle tendinosis.
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