Bipolar Radiofrequency Microtenotomy: Can It Be An Effective Alternative For Plantar Fasciosis?

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Author(s): 
Bora Rhim, DPM

   There is a concern that bipolar radiofrequency could potentially cause excessive adjacent tissue damage.9 However, Kaplan and Uribe showed that chondrocytes still remain viable immediately below the surface of the radiofrequency treatment area.13

Other Considerations With The Bipolar Radiofrequency Microtenotomy

There are several considerations to keep in mind when treating plantar fasciosis with the radiofrequency technique. If the patient has inadequate dorsiflexion to the ankle, one should consider an adjunct procedure such as gastroc lengthening. If the patient has biomechanical faults that are contributing to the symptoms of plantar fasciosis that are causing severe tension to the plantar fascia, then consider surgical treatment that reduces the tension to the plantar fascia or custom orthotics after the surgery.

   To develop a more comprehensive understanding of the effects of bipolar radiofrequency, additional research is required. A serial examination of in vivo samples treated with Coblation would yield powerful data to help delineate its potential role in tendon or ligamentous degeneration. In addition, a study with a larger clinical group with longer follow-up is necessary to understand the long-term effects of this technology upon the natural history of plantar fasciosis.

   With careful patient selection and adherence to the recommended technique, bipolar radiofrequency microtenotomy offers the patient and practitioner hope in the treatment of chronic plantar fasciosis.

In Conclusion

This minimally invasive technique is a viable surgical treatment option for patients with recalcitrant plantar fasciosis who have failed conservative care. However, proper patient selection is key with this surgical treatment option. While this technique offers a surgical alternative to conventional surgery, one should avoid using this technique on inflammatory conditions.

   There is still a need for further study to investigate the long-term outcomes of the procedure in the treatment of recalcitrant plantar fasciosis. I still believe that the future of plantar fasciosis treatment is in stimulating treatments that allow the body to heal itself without sacrificing the plantar fascia.

   Dr. Rhim is an Assistant Professor at the College of Podiatric Medicine, Surgery, and Biomechanics at the Western University of Health Sciences, Pomona, Ca.



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