Korean J Sports Med.  2017 Dec;35(3):155-161. 10.5763/kjsm.2017.35.3.155.

Preliminary Clinical Results of Topaz Microdebridement Procedure in Lateral Epicondylitis Patients

Affiliations
  • 1Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. shoulder.yoo@samsung.com
  • 2Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

Abstract

The purpose of this study is to clinically evaluate and report the effectiveness of radiofrequency microdebrider (Topaz, ArthroCare) treatment in lateral epicondylitis patients. From March to July 2003, 15 patients of 17 elbows were prospectively followed. Candidate for the treatment were lateral epicondylitis patients who had symptom more than 6 month and failed to respond to conservative treatment, including medication (non-steroidal anti-inflammatory drugs), external gel or patch, and steroid injections. All patient who scored greater than grade 3 (fair) on the Self-administered Roles and Maudsley Pain (SRMP) score were selected for the procedure. All procedure was done using local anesthesia and ArthroCare microdebrider by a single surgeon. Postoperative assessments were done on postoperative period 12 month of two previous subjective scores and a simple functional assessment asking better, same, or worst function after the procedure. Mean age of the patients was 45 years old. Mean symptom duration before the procedure was 22.6 months. After the procedure, the mean Pain Visual Analogue Scale improved from 7.3 (range, 5-9; standard deviation [SD], 1.2) preoperatively to 3.7 (range, 0-7; SD, 2.1) postoperatively (p< 0.001). After the procedure, five elbows showed no rating improvement, in seven elbows 1 level improvement, in four elbows 2 level improvement, and in one elbow 3 level improvement. Overall, 71% (12/17) showed improvement after the procedure according to the SRMP score rating. Although 29% (5/17) of the elbow showed no improvement on SRMP score, among them five elbows were still rated decrease in Pain Visual Analogue Scale.

Keyword

Microtenotomy; Tennis elbow; Visual Analogue Pain Scale

MeSH Terms

Anesthesia, Local
Elbow
Humans
Pain Measurement
Postoperative Period
Prospective Studies
Tennis Elbow

Figure

  • Fig. 1 (A) ArthroCare timer and (B) Topaz device. This additional equipment is needed with the conventional ArthroCare device.

  • Fig. 2 The pathologic tendon is localized and the Topaz device is inserted perpendicular to the tendon. It is activated 0.5 second with 5-mm distance intervals with grid-like pattern.

  • Fig. 3 Pre- and postoperative comparison of Pain Visual Analogue Scale (PVAS).

  • Fig. 4 Pre- (Preop) and postoperative (Postop) distribution of the Self-administered Roles and Maudsley Pain score.


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