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. 2020 Jan 24;8(1):2325967119895602.
doi: 10.1177/2325967119895602. eCollection 2020 Jan.

Radiofrequency Microdebridement as an Adjunct to Arthroscopic Surgical Treatment for Recalcitrant Gluteal Tendinopathy: A Double-Blind, Randomized Controlled Trial

Caroline M Blakey  1   2 , John O'Donnell  1   3   4 , Ianiv Klaber  5 , Parminder Singh  1   3 , Manit Arora  6 , Amir Takla  4 , Jane Fitzpatrick  7   8   9
Affiliations

Radiofrequency Microdebridement as an Adjunct to Arthroscopic Surgical Treatment for Recalcitrant Gluteal Tendinopathy: A Double-Blind, Randomized Controlled Trial

Caroline M Blakey et al. Orthop J Sports Med. .

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).

Keywords: bursitis; gluteal tendinopathy; gluteal tendon tear; greater trochanteric pain syndrome; hip arthroscopic surgery; radiofrequency microdebridement.

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Conflict of interest statement

One or more of the authors declared the following potential conflict of interest or source of funding: J.O. has received consulting fees from Medacta and Smith & Nephew. J.F. has been on the medical advisory board for Bioventus Global. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Arthroscopic radiofrequency microdebridement (RFMD) of the superior surface of the gluteal tendons of the hip.
Figure 2.
Figure 2.
Flowchart of study patients. AGB, arthroscopic gluteal bursectomy; F-U, follow-up; ITBR, iliotibial band release; mHHS, modified Harris Hip Score; RFMD, radiofrequency microdebridement.
Figure 3.
Figure 3.
Modified Harris Hip Score (mHHS) at baseline and 6, 12, 24, and 52 weeks. AGB, arthroscopic gluteal bursectomy; ITBR, iliotibial band release; RFMD, radiofrequency microdebridement.
See this image and copyright information in PMC

References

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