Radiofrequency Microtenotomy for the Treatment of Chronic Insertional Tendinopathy: Comparison of 2 Surgical Techniques and Preliminary Results

Abstract

To determine whether the clinical results of radiofrequency microtenotomy for the treatment of chronic insertional tendinopathy are comparable to those of monopolar electrocautery. Sixteen patients with chronic knee and elbow tendon injuries who were refractory to conservative therapy, between January 2006 and July 2007, were selected in the surgical ward of Hospital de Clínicas de Porto Alegre, Brazil. Eight patients underwent microtenotomy with a Topaz probe (Arthrocare) whereas the remaining 8 patients underwent microtenotomy with monopolar electrocautery. The patients were assessed using a Visual Analog Pain Scale and the Mayo Elbow Performance Score. Statistically significant differences with regard to the relief of pain were perceived in both groups on postoperative day 7. Both groups showed remarkable alleviation of pain after the seventh day and their pain scores decreased over time. Most patients (75%) scored 1 or less on the pain scale 3 months after surgery. In contrast, at 6 months, 93.7% of the patients scored 1 or less on the pain scale. The groups did not show any differences in terms of the Mayo Elbow Performance Score. On postoperative day 14, 77% of the patients had a score greater than 75, which is rated as good. After 6 months, all patients had good and excellent outcomes. Radiofrequency microtenotomy, either with a Topaz probe or with conventional electrocautery, yielded good and excellent results, respectively, for the treatment of chronic insertional tendinopathy.

Conventional rotator cuff repair complemented by the aid of mononuclear autologous stem cells

“…Studies have been conducted in cardiology [ 1 ], neurology [ 38 ], dentistry [ 32 ], and so forth. There are, however, few publications in the orthopedic field [ 2 – 5 ] addressing the use of BMMC in the recovery of tendons in rotator cuff tears.…”

“…Quadriceps and patellar tendinopathy, as well as epicondylitis (tennis elbow), behave similarly with respect to the development of tendon degeneration [ 11 , 27 ]. In these diseases, new treatments have gained ground trying to stimulate tendon regeneration, including shockwave therapy [ 13 ], microtenotomy, and thermal stimulation [ 5 , 39 ]. Their purpose is to cause “controlled damage” to the tendon in order to stimulate repair of the tendon structure via inflammatory reaction, i.e., recruitment of cells and angiogenesis.…”

Percutaneous microtenotomy using a microdebrider coblation wand for the treatment of lateral epicondylitis: A systematic review

“…[12] Additionally, they found no significant difference ( P = .80) in return to basic activities of daily living between the microtenotomy (2.6 ± 1.8 days) and electrocautery groups (2.8 ± 1.6 days). [12]…”

“…[15] There was also a wide range of follow-up times reported by the studies. Some studies had their final follow-up 12 months postprocedure, [13,14] while other studies had as low as 6 months [12,18] or as high as 24 months. [15,19] Tasto et al reported that their follow-up of patients ranged from 6 months to 9 years with an average of 2.5 years.…”

“…[18] Canquerini and Gomes reported that 100% of patients were satisfied. [12] Three studies determined surgical success based on different measurements. [12,15,20] Tasto et al (2016) defined clinical success as "pain improvement >50%"; 91% of patients achieved this clinically successful outcome.…”