Is percutaneous radiofrequency coblation for treatment of Achilles tendinosis safe and effective?

Insertional Achilles tendinosis results in isolated pain at the Achilles tendon insertion site due to intratendinous degeneration. When conservative measures fail, surgical treatment may be necessary. Radiofrequency coblation has been suggested to be an effective procedure for treatment of tendon pathologies. Percutaneous execution of this procedure is very simple as well as minimally invasive, and thus if effective, would be an excellent alternative to an open treatment of insertional Achilles tendinopathy. A review of 47 cases with this percutaneous technique was conducted. In our relatively short-term follow-up (mean = 8.6 months, SD = 9.71, range 1 to 40), the incidence of reoperation was 14.9% (7/47). Rupture of the Achilles tendon was identified in 3 (6.4%) patients. Our cohort had a relatively high body mass index (mean = 37.1, SD = 6.96, range 24.3 to 52.8). We recommend surgeons to be cautious about selecting this procedure in similar, high body mass index patient cohorts for treatment of Achilles tendinosis.