Open vs Percutaneous TOPAZ Coblation for the Management of Plantar Fasciitis: Comparison of the Two Techniques in Obese Patients

Abstract

Plantar fasciopathy is known to be the most common cause of heel pain. Obese patients are known to have an increased probability of suffering from this condition. The technique of radiofrequency (RF) coblation, comparing open vs percutaneous methods, and its outcomes, has not been studied in the subgroup of patients. Patients treated operatively by RF coblation in our institution for plantar fasciitis between 2007 and 2015 were grouped into whether they received the open or percutaneous microtenotomy. The patients were interviewed at baseline and 3 months, 6 months, and 12 months postoperatively using the American Orthopedic Foot and Ankle Society (AOFAS) and 36-item Medical Outcomes Short Form (SF-36) questionnaires. Patients in both arms had an overall improvement in the visual analog scale (VAS) pain score and AOFAS ankle–hindfoot scores. The SF-36 scores also showed improvement across all areas postoperatively. There was also a significant improvement in expectation and satisfaction scores. However, those who had open RF microtenotomy fared better at 3 months, with regard to the visual analog score and both at 3 months and 6 months for the AOFAS hindfoot scores. There were no difference comparing both techniques with regard to the SF-36 scores. Radiofrequency microtenotomy is a safe and effective procedure for the treatment of plantar fasciitis even in the obese group of patients. Both open and percutaneous methods have achieved good patient outcomes and expectation, although the open group showed superior pain and functional outcomes at early follow-up. Wenxian PNG, Thien KKO. Open vs Percutaneous TOPAZ Coblation for the Management of Plantar Fasciitis: Comparison of the Two Techniques in Obese Patients. J Foot Ankle Surg (Asia Pacific) 2020;7(1):14–20.