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Podiatry

Minimally-invasive technique repairs Achilles tendinosis and plantar fascitis

03/01/2007

Achilles tendinosis and plantar fascitis are two of the most common causes of heel and foot pain. Coblation offers patients a minimally invasive treatment for these conditions when non-surgical treatments fail. This technique uses a specialized probe to pinpoint specific, localized damage to the tendon or fascia and effectively repair the tendon or fascia and increase mobility in the foot.

Tendinosis and plantar fascitis

Achilles tendinosis results from scar tissue caused by small tears in the tendon and is often associated with chronic stiffness and pain. The scar tissue on the tendon can lead to swelling and poor circulation, known as hypovascularity, which cannot be reversed without treatment. If conservative therapies are not effective, more aggressive treatment may be required in the long term.

Plantar fascitis is also caused by small tears and inflammation. The plantar fascia, a continuation of the Achilles tendon, is a strong ligament on the bottom of the foot. It helps transfer the pull of the Achilles tendon to the foot by stretching and contracting. People with flat feet or tightness of the fascia place the ligament under constant stress, which in turn can cause the ligament to pull away from its origin in the heel bone.

In both Achilles tendinosis and plantar fascitis, pain and swelling are caused by scar tissue that gradually decreases blood flow to the affected region. A lack of circulation combined with slow micro-tearing of the tendon or fascia may lead to chronic scarring.

Who is a candidate for coblation?

Often, conservative care for Achilles tendinosis and plantar fascitis – including stretching, physical therapy and orthotic insoles – may offer some temporary relief. For those whose pain continues for more than six months, surgical intervention may be recommended.

About the procedure

Unlike other treatments that use heat to destroy scar tissue, coblation uses a constant stream of water infiltration to pinpoint and correct damage to the tendon without causing a burn that, in turn, can lead to more scar tissue. Using ultrasound guidance, this microscopic device is applied directly to the affected area to destroy the localized scar tissue fibers, leaving the surrounding tissues unaffected. The probe is also applied to the tendon or fascia to help create new microscopic tunnels in the region to increase circulation.

Coblation is performed under a local anesthetic in an outpatient setting. Patients can expect a short recovery time ranging from one week to a month depending on the amount of damage to the treated area. This procedure requires only a tiny nick in the skin and patients are able to put weight on their foot immediately afterwards and can expect to be back in a soft supportive shoe within a week.

Contact information

Bob Baravarian, DPM
Assistant Clinical Professor UCLA Division of Podiatry
Co-director, The Foot and Ankle Institute
(310) 828-0011

http://www.footankleinstitute.com




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