Radio Frequency Topaz Microdebrider for Chronic Heel Pain
Heel pain is a common presenting complaint causing patients to seek a foot and ankle surgeon or doctor. One of the most common etiologies of heel pain is mechanical or repetitive overuse injury causing inflammation of the plantar fascia, termed Plantar Fasciitis.
Symptoms of Plantar Fasciitis
- Pain and stiffness in heel (can be worse in morning)
- Inability to walk long distances
- Swelling around heel
Causes and Risk factors of Plantar Fasciitis
- Repetitive loading or exercise
- Change in activity level, duration, or training surfaces
- Recent activity/long walking in unsupportive shoes or sandals
- Abnormal foot mechanics and architecture
- Recent weight gain or obesity
- Acute trauma or injury
Conservative treatment options for Plantar fasciitis
- Icing
- Stretching of the Achilles tendon and plantar fascia complexes
- Rest or activity modifications
- Custom orthotics or over-the-counter orthotics
- Supportive and comfortable shoes
- Oral anti-inflammatories
- Physical therapy modalities
- Heel injections
- Night splints
Plantar fasciitis generally resolves with conservative management, however certain cases even fail 6 months of conservative treatment and may require surgical procedures to help alleviate the symptoms. Podiatry Research has demonstrated that chronic injury and inflammation to the plantar fascia leads to micro-tears and degeneration of the plantar fascia, termed plantar fasciosis. Plantar fasciosis lacks acute inflammatory tissue, accordingly, rendering conservative options unsuccessful at times.
Surgical options for Recalcitrant Plantar Fasciitis and Plantar Fasciosis
- Topaz (ArthroCare) Microdebrider
- Platelet Rich Plasma injection
- Shockwave therapy
- Open and Endoscpoic Realease
Topaz Coblation Microdebrider procedure is a minimally invasive surgical technique utilizing small holes to break up the scar tissue and attempt revascularization of the plantar fascia. By “burning holes” into the ligament, the Topaz will turn a chronic process into an acute inflammatory process to cause an influx of inflammatory healing cells directly into the ligament.
The procedure is performed in the operating room. The anesthesia team will administer sedation medications and then a local nerve block is performed by the foot surgeon. The surgeon will then mark the area of the plantar fascia and make holes in the skin. The topaz probe is then placed through these holes into the plantar fascia. The patient is then placed into a walking boot for a period of 2 to 3 weeks during the healing process.
The procedure only requires small holes compared to a larger open incision and surgery. This lends to quicker healing and less pain and scar tissue and faster recovery.
Click below to watch a video of the Topaz heel pain treatment procedure.
Video: Topaz Procedure for Chronic Plantar Fasciitis Heel Pain
Think the Topaz procedure might help you? For help with your heel pain, contact UFAI, California’s leaders in foot and ankle care. To an appointment please Call 877-501-0193 or Request a Heel Pain Consultation online.
Dr. Baravarian has been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy and trauma/reconstructive surgery of the foot and ankle. He servers as a consultant to the ATP (Association of Tennis Professionals) tour, multiple running organizations and several shoe manufacturers. He is also fluent in five languages (English, French, Spanish, Farsi and Hebrew),
Podiatrist Dr. Bob Baravarian is available for consultation at the Santa Monica, Sherman Oaks and UCLA Westwood offices.
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I am orthopedic surgeon and would like to know about topaz surgery for Plantar Fasciitis?
Greetings Naseeb,
Firstly, please visit our page on Topaz here: https://www.footankleinstitute.com/treatments/topaz-procedure (if you have not already). As you may know, Topaz is just one tool of quite a few to treat Plantar Fasciitis. Which is right for you? That is determined by your doctor. If you want to setup an appointment you can do that here: https://www.footankleinstitute.com/make-an-appointment.
I hope this helps!