Radiofrequency-Based Plasma Microtenotomy Compared With Arthroscopic Subacromial Decompression Yields Equivalent Outcomes for Rotator Cuff Tendinosis

Ettore Taverna, Ferdinando Battistella, Valerio Sansone, Carlo Perfetti, James P. Tasto

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Purpose: This study aimed to determine whether radiofrequency (RF)-based plasma microtenotomy (microdebridement) was effective for treating chronic supraspinatus tendinosis. Methods: The institutional ethics committee approved the study design, and all patients signed informed consent forms. Patients (age range, 30 to 70 years) were considered for enrollment if 6 months of active conservative treatment had failed and they had Neer stage II impingement syndrome, positive radiographic evidence of type II acromion, and magnetic resonance imaging or ultrasound evidence of supraspinatus tendinosis. Patients (N = 60) were randomly assigned to undergo arthroscopic subacromial decompression or RF-based plasma microtenotomy. For microtenotomy, a bipolar RF-based probe (TOPAZ; ArthroCare, Austin, TX) was used to perform microdebridement in the supraspinatus tendon; patients did not undergo acromioplasty. Outcomes evaluation consisted of self-reported pain via a visual analog scale, as well as functional assessment (American Shoulder and Elbow Surgeons [ASES] survey, Constant score, and University of California, Los Angeles [UCLA] questionnaire). Statistical analyses were performed by use of factorial dependent-measures analysis of variance tests. Results: Age and baseline scores on the visual analog scale (mean ± SD) were 52.0 ± 6.7 and 53.2 ± 6.6 years and 8.4 ± 0.9 and 8.2 ± 0.8 points in the microtenotomy and arthroscopic subacromial decompression groups, respectively. A significant reduction in pain (P <.001) and improved function (P <.001 for all measures) were observed in both groups postoperatively. Both treatment groups had almost identical longitudinal recovery profiles for pain relief (P = .416) and restoration of function (P = .964 for ASES score, P = .978 for Constant score, and P = .794 for UCLA score). At 1 year, the median pain score was 1.0, and all patients had ASES, Constant, and UCLA scores of greater than 90, greater than 80, and greater than 30, respectively. Conclusions: Both procedures were associated with significant improvement postoperatively, but the RF-based plasma microtenotomy procedure draws into question the need for a more extensive procedure such as subacromial decompression in this patient population. Level of Evidence: Level I, therapeutic randomized controlled study.

Fingerprint

Decompression
Rotator Cuff
Los Angeles
Elbow
Pain
Tendinopathy
Visual Analog Scale
Acromion
Consent Forms
Ethics Committees
Tendons
Rotator Cuff Injuries
Analysis of Variance
Magnetic Resonance Imaging
Therapeutics
Population
Surgeons

Keywords

  • Arthroscopic subacromial decompression
  • Bipolar radiofrequency
  • Microdebridement
  • Microtenotomy
  • Plasma
  • Shoulder surgery
  • Tendon debridement

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

@article{fc66df398ee34cfa9efb977d0da7aed9,
title = "Radiofrequency-Based Plasma Microtenotomy Compared With Arthroscopic Subacromial Decompression Yields Equivalent Outcomes for Rotator Cuff Tendinosis",
abstract = "Purpose: This study aimed to determine whether radiofrequency (RF)-based plasma microtenotomy (microdebridement) was effective for treating chronic supraspinatus tendinosis. Methods: The institutional ethics committee approved the study design, and all patients signed informed consent forms. Patients (age range, 30 to 70 years) were considered for enrollment if 6 months of active conservative treatment had failed and they had Neer stage II impingement syndrome, positive radiographic evidence of type II acromion, and magnetic resonance imaging or ultrasound evidence of supraspinatus tendinosis. Patients (N = 60) were randomly assigned to undergo arthroscopic subacromial decompression or RF-based plasma microtenotomy. For microtenotomy, a bipolar RF-based probe (TOPAZ; ArthroCare, Austin, TX) was used to perform microdebridement in the supraspinatus tendon; patients did not undergo acromioplasty. Outcomes evaluation consisted of self-reported pain via a visual analog scale, as well as functional assessment (American Shoulder and Elbow Surgeons [ASES] survey, Constant score, and University of California, Los Angeles [UCLA] questionnaire). Statistical analyses were performed by use of factorial dependent-measures analysis of variance tests. Results: Age and baseline scores on the visual analog scale (mean ± SD) were 52.0 ± 6.7 and 53.2 ± 6.6 years and 8.4 ± 0.9 and 8.2 ± 0.8 points in the microtenotomy and arthroscopic subacromial decompression groups, respectively. A significant reduction in pain (P <.001) and improved function (P <.001 for all measures) were observed in both groups postoperatively. Both treatment groups had almost identical longitudinal recovery profiles for pain relief (P = .416) and restoration of function (P = .964 for ASES score, P = .978 for Constant score, and P = .794 for UCLA score). At 1 year, the median pain score was 1.0, and all patients had ASES, Constant, and UCLA scores of greater than 90, greater than 80, and greater than 30, respectively. Conclusions: Both procedures were associated with significant improvement postoperatively, but the RF-based plasma microtenotomy procedure draws into question the need for a more extensive procedure such as subacromial decompression in this patient population. Level of Evidence: Level I, therapeutic randomized controlled study.",
keywords = "Arthroscopic subacromial decompression, Bipolar radiofrequency, Microdebridement, Microtenotomy, Plasma, Shoulder surgery, Tendon debridement",
author = "Ettore Taverna and Ferdinando Battistella and Valerio Sansone and Carlo Perfetti and Tasto, {James P.}",
year = "2007",
month = "10",
doi = "10.1016/j.arthro.2007.04.018",
language = "English",
volume = "23",
pages = "1042--1051",
journal = "Arthroscopy - Journal of Arthroscopic and Related Surgery",
issn = "0749-8063",
publisher = "W.B. Saunders Ltd",
number = "10",

}

TY - JOUR

T1 - Radiofrequency-Based Plasma Microtenotomy Compared With Arthroscopic Subacromial Decompression Yields Equivalent Outcomes for Rotator Cuff Tendinosis

AU - Taverna, Ettore

AU - Battistella, Ferdinando

AU - Sansone, Valerio

AU - Perfetti, Carlo

AU - Tasto, James P.

PY - 2007/10

Y1 - 2007/10

N2 - Purpose: This study aimed to determine whether radiofrequency (RF)-based plasma microtenotomy (microdebridement) was effective for treating chronic supraspinatus tendinosis. Methods: The institutional ethics committee approved the study design, and all patients signed informed consent forms. Patients (age range, 30 to 70 years) were considered for enrollment if 6 months of active conservative treatment had failed and they had Neer stage II impingement syndrome, positive radiographic evidence of type II acromion, and magnetic resonance imaging or ultrasound evidence of supraspinatus tendinosis. Patients (N = 60) were randomly assigned to undergo arthroscopic subacromial decompression or RF-based plasma microtenotomy. For microtenotomy, a bipolar RF-based probe (TOPAZ; ArthroCare, Austin, TX) was used to perform microdebridement in the supraspinatus tendon; patients did not undergo acromioplasty. Outcomes evaluation consisted of self-reported pain via a visual analog scale, as well as functional assessment (American Shoulder and Elbow Surgeons [ASES] survey, Constant score, and University of California, Los Angeles [UCLA] questionnaire). Statistical analyses were performed by use of factorial dependent-measures analysis of variance tests. Results: Age and baseline scores on the visual analog scale (mean ± SD) were 52.0 ± 6.7 and 53.2 ± 6.6 years and 8.4 ± 0.9 and 8.2 ± 0.8 points in the microtenotomy and arthroscopic subacromial decompression groups, respectively. A significant reduction in pain (P <.001) and improved function (P <.001 for all measures) were observed in both groups postoperatively. Both treatment groups had almost identical longitudinal recovery profiles for pain relief (P = .416) and restoration of function (P = .964 for ASES score, P = .978 for Constant score, and P = .794 for UCLA score). At 1 year, the median pain score was 1.0, and all patients had ASES, Constant, and UCLA scores of greater than 90, greater than 80, and greater than 30, respectively. Conclusions: Both procedures were associated with significant improvement postoperatively, but the RF-based plasma microtenotomy procedure draws into question the need for a more extensive procedure such as subacromial decompression in this patient population. Level of Evidence: Level I, therapeutic randomized controlled study.

AB - Purpose: This study aimed to determine whether radiofrequency (RF)-based plasma microtenotomy (microdebridement) was effective for treating chronic supraspinatus tendinosis. Methods: The institutional ethics committee approved the study design, and all patients signed informed consent forms. Patients (age range, 30 to 70 years) were considered for enrollment if 6 months of active conservative treatment had failed and they had Neer stage II impingement syndrome, positive radiographic evidence of type II acromion, and magnetic resonance imaging or ultrasound evidence of supraspinatus tendinosis. Patients (N = 60) were randomly assigned to undergo arthroscopic subacromial decompression or RF-based plasma microtenotomy. For microtenotomy, a bipolar RF-based probe (TOPAZ; ArthroCare, Austin, TX) was used to perform microdebridement in the supraspinatus tendon; patients did not undergo acromioplasty. Outcomes evaluation consisted of self-reported pain via a visual analog scale, as well as functional assessment (American Shoulder and Elbow Surgeons [ASES] survey, Constant score, and University of California, Los Angeles [UCLA] questionnaire). Statistical analyses were performed by use of factorial dependent-measures analysis of variance tests. Results: Age and baseline scores on the visual analog scale (mean ± SD) were 52.0 ± 6.7 and 53.2 ± 6.6 years and 8.4 ± 0.9 and 8.2 ± 0.8 points in the microtenotomy and arthroscopic subacromial decompression groups, respectively. A significant reduction in pain (P <.001) and improved function (P <.001 for all measures) were observed in both groups postoperatively. Both treatment groups had almost identical longitudinal recovery profiles for pain relief (P = .416) and restoration of function (P = .964 for ASES score, P = .978 for Constant score, and P = .794 for UCLA score). At 1 year, the median pain score was 1.0, and all patients had ASES, Constant, and UCLA scores of greater than 90, greater than 80, and greater than 30, respectively. Conclusions: Both procedures were associated with significant improvement postoperatively, but the RF-based plasma microtenotomy procedure draws into question the need for a more extensive procedure such as subacromial decompression in this patient population. Level of Evidence: Level I, therapeutic randomized controlled study.

KW - Arthroscopic subacromial decompression

KW - Bipolar radiofrequency

KW - Microdebridement

KW - Microtenotomy

KW - Plasma

KW - Shoulder surgery

KW - Tendon debridement

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