Surgical treatment of chronic non-insertional Achilles tendinopathy in runners using bipolar radiofrequency

Arnal-Burró, J.; López-Capapé, D.; Igualada-Blázquez, C; Ortiz-Espada, A.; Martin-García, Ana

doi:10.1016/j.recote.2016.01.003

Cited by 4 publications

(5 citation statements)

References 30 publications

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“…The underlying mechanism to explain the effect of RF interventions is that the thermal energy applied to the diseased tendon destroys the newly formed blood vessels together with the sensory nerves that accompany them. 20 Arnal-Burro et al 6 conducted a retrospective case series consisting of 17 Achilles tendon surgical procedures using RFM in 13 patients who were habitual runners with noninsertional AT. The authors found an improvement in 94% of symptoms and a return to the previous activity in 70% of the cases at the 12-month follow-up.…”

Section: Discussionmentioning

confidence: 99%

“… 35 Takahashi et al 34 have suggested that radiofrequency (RF) induces acute degeneration and/or ablation of sensory nerve fibers, which might explain the early pain relief after RFM for patients with tendinopathy. Bipolar RFM has shown promising results in treating tendinosis of the lateral epicondyle, 24 plantar fascia, patellar and Achilles tendons, 6 , 21 and shoulder tendons. 1 , 37 In a nonrandomized study using RFM, Arnal-Burro et al 6 treated 17 Achilles tendons in 13 patients who were active runners and obtained a 94% improvement in symptoms and a return to previous performance in 70% of cases at the 12-month follow-up.…”

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confidence: 99%

“…Bipolar RFM has shown promising results in treating tendinosis of the lateral epicondyle, 24 plantar fascia, patellar and Achilles tendons, 6 , 21 and shoulder tendons. 1 , 37 In a nonrandomized study using RFM, Arnal-Burro et al 6 treated 17 Achilles tendons in 13 patients who were active runners and obtained a 94% improvement in symptoms and a return to previous performance in 70% of cases at the 12-month follow-up. In a retrospective study, Yeap et al 40 treated tendinosis in the Achilles, tibialis, and peroneal tendons using RF coblation and found a significant reduction in pain and a significant improvement in function 3 months after surgery.…”

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confidence: 99%

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Radiofrequency Microtenotomy or Physical Therapy for Achilles Tendinopathy: Results of a Randomized Clinical Trial

Al-Ani

Meknas

Kartus

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Achilles tendinopathy is a painful disorder, and various treatment options are available. Bipolar radiofrequency microtenotomy (RFM) has shown promising results in treating tendinosis. Purpose/Hypothesis: The purpose was to compare the results between treatment with bipolar RFM and physical therapy (PT) for patients with midportion Achilles tendinopathy. It was hypothesized that RFM would be equivalent or superior to PT. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 38 patients with midportion Achilles tendinopathy were evaluated for 2 years. The patients were randomized to receive either RFM or PT. There were 20 patients in the RFM group and 18 patients in the PT group. Clinical outcomes were assessed using the visual analog scale (VAS) for pain and the Foot and Ankle Outcome Score (FAOS). The degree of tendinosis was evaluated with magnetic resonance imaging (MRI) of the affected ankle performed before intervention and 2 years after intervention. Results: In both groups, the VAS scores at the 2-year follow-up were significantly improved compared with preintervention: from 7.2 ± 1.5 to 1.0 ± 1.4 for the RFM group and from 5.9 ± 1.3 to 3.1 ± 1.8 for the PT group ( P < .01 for both). Compared with the PT group, the RFM group had significantly better VAS scores at both the 1- and 2-year follow-ups ( P < .01 for both) and better scores on 4 of the 5 FAOS subscales at the 2-year follow-up ( P < .01 for all). MRI revealed an improvement in the tendinosis score in both groups, without any significant difference between the groups. Conclusion: In this randomized study, the clinical assessments revealed significant improvements in the VAS, FAOS, and tendinosis score as seen on MRI 2 years after intervention with either RFM or PT in patients with midportion Achilles tendinopathy. The improvement was significantly better in the RFM group with regard to VAS and FAOS, but not in the MRI appearance. Registration: NCT03274557 ( ClinicalTrials.gov identifier).

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Radiofrequency Microtenotomy or Physical Therapy for Achilles Tendinopathy: Results of a Randomized Clinical Trial

Al-Ani

Meknas

Kartus

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…Bipolar radiofrequency microtenotomy (RFM) has shown promising results in treating tendinosis of the lateral epicondyle [23], plantar fascia, patellar and Achilles tendon [1, 22], and shoulder [32]. Interestingly, Pineda et al reported a good outcome in terms of pain relief and muscle relaxation using radiofrequency neurotomy at the genicular nerves in patients who suffered from knee osteoarthritis [30].…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency microtenotomy: a promising method for treatment of rotator cuff tendinopathy

Al-Ani

Jacobsen

Kartus

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose Subacromial pain syndrome is a common disorder. Arthroscopic subacromial decompression is currently the preferred treatment method. Bipolar radiofrequency microtenotomy has shown promising results in treating tendinosis. In this study, the authors compare the results after arthroscopic acromioplasty with bipolar radiofrequency microtenotomy for patients with subacromial pain syndrome. Methods A total of 27 patients, with subacromial pain syndrome, were followed for 2 years. There were 14 patients in the arthroscopic acromioplasty group and 13 patients in the radiofrequency microtenotomy group. Clinical outcome data included pain reported using a visual analog scale, Constant score, and strength. Magnetic resonance imaging of the afected shoulder was performed before and 2 years after intervention for an evaluation of the tendinosis grade. Results All patients attended the inal follow-up 2 years after intervention. No signiicant diferences were found at baseline between the groups. Pain measured by the visual analog scale revealed a signiicant reduction in both groups at 12 weeks, 6 months and 2 years compared with baseline. There was no signiicant diference between the groups in terms of visual analog scale, Constant score, or strength. The magnetic resonance imaging revealed a signiicant improvement in the tendinosis score in both groups, without any signiicant diference between the groups. Conclusion In this prospective randomized study, the clinical assessments revealed a signiicant improvement in terms of the visual analog scale, strength, Constant score, and tendinosis score 2 years after intervention with either arthroscopic acromioplasty or radiofrequency microtenotomy in patients with subacromial pain syndrome. However, no signiicant diferences were found between the groups. This study reveals that there are surgical options other than acromioplasty in patients with SAPS. Level of evidence II.

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“…Actualmente, autores como Arnal-Burró et al, (2015); De Carbo & Bullock (2017); Sánchez & Seoane (2018); Jennings, Liew, & Marine (2019), que tras los hallazgos histopatológicos y ecográficos estudiados están llegando a la conclusión de que la mayoría de las tendinopatías están asociadas y relacionadas a un único factor, que es la existencia de un proceso degenerativo previo a la rotura.…”

Section: Introductionunclassified

La electrólisis percutánea y su eficacia en el tratamiento de tendinopatías en la extremidad inferior. Revisión sistemática

Arévalo

Allaica

García

et al. 2019

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En los últimos años, la concepción que se tenía de las tendinopatías ha tolerado grandes cambios. La separación de las teorías que declaran a las tendinopatías como trastornos inflamatorios, a teorías que aluden una fisiopatología de carácter continúo basado en cambios degenerativos, propició la aparición de técnicas de fisioterapia invasiva como la electrólisis percutánea, que buscan romper con este proceso de degeneración, permitiendo la recuperación del tejido. El objetivo general de esta revisión sistemática es, estudiar la eficacia y evidencia científica de la técnica del electrólisis percutánea aplicada al tratamiento de tendinopatías en la extremidad inferior, para comparar los resultados obtenidos. Para lo cual, se realizó una búsqueda sistemática de estudios en 6 bases de datos, empleando las palabras clave: patellar tendinopathy unido con electrolysis, treatment, physical therapy y rehabilitation, lo cual ofreció 28 artículos, de los cuales, 8 se emplearon en la revisión, concretamente, 5 estudios de series de casos y 2 estudios prospectivos en ratas y 1 caso clínico. La electrólisis percutánea, mostró una mejora funcional y en la sensación dolorosa, al ser combinada con terapias de ejercicios excéntricos. El tratamiento terapéutico de las tendinopatías en la extremidad inferior mediante electrólisis percutánea, brinda resultados muy promisorios, sin embargo, para establecer la consecuencia de estos resultados, requiere del aporte de una cantidad sustancialmente mayor de estudios con una metodología más sofisticada, que sustenten su evidencia científica.

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Surgical treatment of chronic non-insertional Achilles tendinopathy in runners using bipolar radiofrequency

Cited by 4 publications

References 30 publications

Radiofrequency Microtenotomy or Physical Therapy for Achilles Tendinopathy: Results of a Randomized Clinical Trial

Radiofrequency Microtenotomy or Physical Therapy for Achilles Tendinopathy: Results of a Randomized Clinical Trial

Radiofrequency microtenotomy: a promising method for treatment of rotator cuff tendinopathy

La electrólisis percutánea y su eficacia en el tratamiento de tendinopatías en la extremidad inferior. Revisión sistemática

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