Efficacy of TOPAZ coblation-assisted percutaneous fasciotomy in chronic plantar fasciitis.

BACKGROUND

Plantar fasciitis is one of the most common causes of chronic heel pain, accounting for up to 10 % of running-related injuries and significantly impacting the quality of life in both active and sedentary populations. While the majority of patients respond to conservative measures such as stretching, physiotherapy, orthoses, steroid injections, and extracorporeal shockwave therapy, approximately 5-10 % remain symptomatic despite prolonged non-operative treatment. Surgical intervention is considered in these refractory cases, with both open and endoscopic plantar fasciotomy traditionally employed. However, these approaches are associated with potential drawbacks, including wound complications, prolonged recovery, and altered foot biomechanics. In recent years, minimally invasive alternatives have been investigated to minimize morbidity while providing effective pain relief. The study was conducted to evaluate the clinical outcomes of percutaneous plantar fasciotomy using the microdebrider TOPAZ coblation wand in patients with recalcitrant plantar fasciitis.

METHODS

A hospital-based, retrospective observational follow-up study in patients with a primary clinical diagnosis of recalcitrant PF, supported radiologically and underwent percutaneous plantar fasciotomy using a microdebrider TOPAZ coblation wand and had a minimum follow-up of 1 year. Outcome was evaluated using the Foot and Ankle Ability Measure (FAAM) Score, Numerical Rating Scale (NRS)

RESULTS

Of the 18 patients included, 16 (88.9 %) were females. Thirteen (72.1 %) were aged 30-50 years. None had anatomical deformity. There was a significant reduction in pain levels from pre-operative NRS scores (mean 7.56) to NRS scores at 1 year (mean 2.83) (p < 0.001). Functional ability improved notably from a pre-operative FAAM score (mean 59.94) to a 1-year FAAM score (mean 91.33) (p < 0.001)

CONCLUSION

Radiofrequency coblation using TOPAZ microdebrider wand is an effective intervention for chronic recalcitrant PF.