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Radiofrequency Microdebridement as an Adjunct to Arthroscopic Surgical Treatment for Recalcitrant Gluteal Tendinopathy: A Double-Blind, Randomized Controlled Trial.
Orthop J Sports Med. 2020 Jan; 8(1):2325967119895602.OJ

Abstract

Background

Recalcitrant greater trochanteric pain is increasingly recognized as an indication for surgical intervention. The arthroscopic approach has become rapidly more common than the open alternative.

Hypothesis

Patients undergoing radiofrequency microdebridement (RFMD) as an adjunct to arthroscopic gluteal bursectomy (AGB) and iliotibial band release (ITBR) will experience better functional improvement than AGB and ITBR alone at 1 year.

Study Design

Randomized controlled trial; Level of evidence, 2.

Methods

A total of 33 patients with failed nonoperative treatment of gluteal tendinopathy were randomly allocated to undergo AGB/ITBR or AGB/ITBR + RFMD. Full-thickness tears were excluded. The primary outcome measure was the modified Harris Hip Score (mHHS) at 52 weeks. Secondary outcome measures included the mHHS, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and 12-item Short Form Health Survey (SF-12), which were evaluated at 0, 6, 12, 24, and 52 weeks. Statistical significance was defined as P < .05.

Results

A total of 33 participants (33 hips; 30 female and 3 male; mean age, 58 years) were randomized; 16 patients underwent AGB/ITBR + RFMD, and 17 underwent AGB/ITBR. Participants' functionality improved in both groups at all time intervals. The mean mHHS score improved from 57.49 ± 10.61 to 77.76 ± 18.40 (P = .004) and from 58.98 ± 12.33 to 79.96 ± 18.86 (P = .001) at 52 weeks in the AGB/ITBR and AGB/ITBR + RFMD groups, respectively, although there was no statistically significant difference between groups. There were no device-related adverse events.

Conclusion

AGB/ITBR led to significant improvements in patients with recalcitrant gluteal tendinopathy. In this small RCT, the addition of RFMD showed no additional benefit to AGB/ITBR but provided a safe adjunct for the surgical management of recalcitrant gluteal tendinopathy.

Registration

NCT01562366 (ClinicalTrials.gov identifier).

Authors+Show Affiliations

Hip Arthroscopy Australia, Richmond, Australia. Sheffield Children's Hospital, Sheffield, UK.Hip Arthroscopy Australia, Richmond, Australia. St Vincent's Private Hospital, East Melbourne, Australia. Swinburne University, Melbourne, Australia.Department of Orthopedic Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.Hip Arthroscopy Australia, Richmond, Australia. St Vincent's Private Hospital, East Melbourne, Australia.Fortis Hospital, Mohali, India.Swinburne University, Melbourne, Australia.Sports Medicine Professionals, Richmond, Australia. Epworth Hospital, Richmond, Australia. University of Melbourne, Parkville, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32047828

Citation

Blakey, Caroline M., et al. "Radiofrequency Microdebridement as an Adjunct to Arthroscopic Surgical Treatment for Recalcitrant Gluteal Tendinopathy: a Double-Blind, Randomized Controlled Trial." Orthopaedic Journal of Sports Medicine, vol. 8, no. 1, 2020, p. 2325967119895602.
Blakey CM, O'Donnell J, Klaber I, et al. Radiofrequency Microdebridement as an Adjunct to Arthroscopic Surgical Treatment for Recalcitrant Gluteal Tendinopathy: A Double-Blind, Randomized Controlled Trial. Orthop J Sports Med. 2020;8(1):2325967119895602.
Blakey, C. M., O'Donnell, J., Klaber, I., Singh, P., Arora, M., Takla, A., & Fitzpatrick, J. (2020). Radiofrequency Microdebridement as an Adjunct to Arthroscopic Surgical Treatment for Recalcitrant Gluteal Tendinopathy: A Double-Blind, Randomized Controlled Trial. Orthopaedic Journal of Sports Medicine, 8(1), 2325967119895602. https://doi.org/10.1177/2325967119895602
Blakey CM, et al. Radiofrequency Microdebridement as an Adjunct to Arthroscopic Surgical Treatment for Recalcitrant Gluteal Tendinopathy: a Double-Blind, Randomized Controlled Trial. Orthop J Sports Med. 2020;8(1):2325967119895602. PubMed PMID: 32047828.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiofrequency Microdebridement as an Adjunct to Arthroscopic Surgical Treatment for Recalcitrant Gluteal Tendinopathy: A Double-Blind, Randomized Controlled Trial. AU - Blakey,Caroline M, AU - O'Donnell,John, AU - Klaber,Ianiv, AU - Singh,Parminder, AU - Arora,Manit, AU - Takla,Amir, AU - Fitzpatrick,Jane, Y1 - 2020/01/24/ PY - 2019/08/20/received PY - 2019/09/11/accepted PY - 2020/2/13/entrez PY - 2020/2/13/pubmed PY - 2020/2/13/medline KW - bursitis KW - gluteal tendinopathy KW - gluteal tendon tear KW - greater trochanteric pain syndrome KW - hip arthroscopic surgery KW - radiofrequency microdebridement SP - 2325967119895602 EP - 2325967119895602 JF - Orthopaedic journal of sports medicine JO - Orthop J Sports Med VL - 8 IS - 1 N2 - Background: Recalcitrant greater trochanteric pain is increasingly recognized as an indication for surgical intervention. The arthroscopic approach has become rapidly more common than the open alternative. Hypothesis: Patients undergoing radiofrequency microdebridement (RFMD) as an adjunct to arthroscopic gluteal bursectomy (AGB) and iliotibial band release (ITBR) will experience better functional improvement than AGB and ITBR alone at 1 year. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 33 patients with failed nonoperative treatment of gluteal tendinopathy were randomly allocated to undergo AGB/ITBR or AGB/ITBR + RFMD. Full-thickness tears were excluded. The primary outcome measure was the modified Harris Hip Score (mHHS) at 52 weeks. Secondary outcome measures included the mHHS, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and 12-item Short Form Health Survey (SF-12), which were evaluated at 0, 6, 12, 24, and 52 weeks. Statistical significance was defined as P < .05. Results: A total of 33 participants (33 hips; 30 female and 3 male; mean age, 58 years) were randomized; 16 patients underwent AGB/ITBR + RFMD, and 17 underwent AGB/ITBR. Participants' functionality improved in both groups at all time intervals. The mean mHHS score improved from 57.49 ± 10.61 to 77.76 ± 18.40 (P = .004) and from 58.98 ± 12.33 to 79.96 ± 18.86 (P = .001) at 52 weeks in the AGB/ITBR and AGB/ITBR + RFMD groups, respectively, although there was no statistically significant difference between groups. There were no device-related adverse events. Conclusion: AGB/ITBR led to significant improvements in patients with recalcitrant gluteal tendinopathy. In this small RCT, the addition of RFMD showed no additional benefit to AGB/ITBR but provided a safe adjunct for the surgical management of recalcitrant gluteal tendinopathy. Registration: NCT01562366 (ClinicalTrials.gov identifier). SN - 2325-9671 UR - https://www.unboundmedicine.com/medline/citation/32047828/Radiofrequency_Microdebridement_as_an_Adjunct_to_Arthroscopic_Surgical_Treatment_for_Recalcitrant_Gluteal_Tendinopathy:_A_Double-Blind,_Randomized_Controlled_Trial L2 - http://journals.sagepub.com/doi/full/10.1177/2325967119895602?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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