Tendinosis improves after bipolar radiofrequency stimulation
Patients’ postoperative VAS pain scores dropped significantly after seven to 10 days.
PHOENIX — While his data showed that bipolar radiofrequency stimulation relieves tendon pain and leads to potential tendon repair, James P. Tasto, MD, credited the trial’s success to a strong foundation of extensive research and background work.
“It took four or five years of research just to establish the dosage and safety levels,” Tasto, an orthopedic surgeon at the Tendon Treatment Center in the San Diego Sports Medicine and Orthopedic Center, told Orthopedics Today in a telephone interview.
The interview followed Tasto’s presentation of six-month follow-up data at the Arthroscopy Association of North America 22nd Annual Meeting in Phoenix.
That data showed bipolar radiofrequency stimulation is a safe and effective treatment of chronic tendinosis. Nineteen of 20 patients in the study improved and there were no complications. Postoperative VAS pain scores fell significantly after seven to 10 days and continued to drop after four to six weeks, three months and six months of follow-up.
Further investigation in the prospective, nonrandomized, single center pilot study, performed at the San Diego facility, continues to support those findings.
“The safety and efficacy have been borne out now in excess of a year,” Tasto said.
Participants had chronic tendinosis of the patellar tendon (jumper’s knee), Achilles tendon or lateral or medial epicondyle (tennis elbow). All patients had symptoms for at least six months (average of 3.5 years) and failed at least three conservative treatments (average of 5.3 treatments).
Patients received open radiofrequency stimulation of the tendon using a bipolar radiofrequency Topaz Wand (ArthroCare Corp., Sunnyvale, Calif.) with generator set at power level 4 (175V RMS).
Investigators placed the wand on the surface of tendons as well as alternating deep penetrations and activated for 0.5 of a second at 5-mm intervals around the symptomatic area. The tendon was stimulated 15 to 20 times over a 3-4cm2 area.
Tasto, a member of the Orthopedics Today Editorial Advisory Board in the Arthroscopy section, said bipolar radiofrequency may be the ideal treatment for patients who do not respond to conservative therapy yet do not require traditional surgery.
Prior to the study, Tasto and fellow investigators compiled a history of radiofrequency research and its use as treatment in other areas of medicine.
Radiofrequency waves have been used successfully in various medical and surgical applications, such as by cardiologists for ablation of arrhythmias and transmyocardial revascularization.
Tasto’s study was the third trial performed to examine the benefits of bipolar radiofrequency stimulation. It will conclude after a two-year follow-up evaluation of the patients,
A prospective, multicenter, controlled study is underway at other facilities regarding the use of the bipolar radiofrequency on the lateral epicondylitis.
For your information:
- Tasto J, Cummings J, Eves W. Treatment of chronic tendinosis with bipolar radiofrequency stimulation. Presented at the Arthroscopy Association of North America 22nd Annual Meeting. April 24-27, 2003. Phoenix.