Topaz Coblation for Planter Fasciitis & Heel Pain
Topaz Coblation Procedure
TOPAZ is a quick, simple and minimally invasive medical technique now available for the treatment of tendons and fascia. The TOPAZ MicroDebrider utilizes patented Coblation® technology, designed to specifically treat tendons and fascia. To date, over 5 million Coblation procedures have been performed. The TOPAZ technique has been associated with quick return to daily activities allowing for significant improvement in patient outcomes.
How TOPAZ Works
Through a small incision, approximately and inch long, the TOPAZ MicroDebrider is applied on and around the tendon for half-second duration treatments placed a quarter inch apart to form a grid-like pattern. With every fourth application, the device is inserted deeper into the tendon - approximately a quarter inch in depth. Small amounts of tissue are removed as a light application of radiofrequency energy is guided into the tissue. TOPAZ treatment typically takes less than 20 minutes to administer. Patients are ready to leave the clinic once recovered from local or light sedation.
Access can be approached open or endoscopically per surgeon's preference
Post Operative Care and Rehabilitation
First 3 weeks-use crutches
Week 4-Week 8
Content provided by ArthroCare®
Click on the roll-over link to learn about Plantar Fasciitis or Heel Pain
Plantar fasciitis is irritation and swelling of the thick tissue on the bottom of the foot.
The plantar fascia is a very thick band of tissue that holds up the bones on the bottom of the foot. This fascia can become inflamed and painful in some people, making walking more difficult.
Risk factors for plantar fasciitis include:
This condition is one of the most common orthopedic complaints relating to the foot.
Plantar fasciitis is commonly thought of as being caused by a heel spur, but research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis.
The most common complaint is pain in the bottom of the heel. It is usually worst in the morning and may improve throughout the day. By the end of the day the pain may be replaced by a dull aching that improves with rest.
Most people complain of increased heel pain after walking for a long period of time.
Exams and Tests
Typical physical exam findings include:
X-rays may be taken to rule out other problems, but having a heel spur is not significant.
Conservative treatment is almost always successful, given enough time. Treatment can last from several months to 2 years before symptoms get better. Most patients will be better in 9 months.
Initial treatment usually consists of:
If these fail, putting the affected foot in a short leg cast (a cast up to but not above the knee) for 3-6 weeks is very often successful in reducing pain and inflammation. Alternatively, a cast boot (which looks like a ski boot) may be used. It is still worn full time, but can be removed for bathing.
Some physicians will offer steroid injections, which can provide lasting relief in many people.
In a few patients, non-surgical treatment fails and surgery to release the tight, inflamed fascia becomes necessary.
Maintaining good flexibility around the ankle, particularly the Achilles tendon and calf muscles, is probably the best way to prevent plantar fasciitis.
Most frequently heel pain is not the result of any single injury, such as a fall or twist, but rather the result of repetitive or excessive heel pounding.
Plantar fasciitis is inflammation of the thick connective tissue on the sole of your foot that attaches to your heel. The pain is usually felt at the bottom of your heel and is often worse in the morning because of stiffness that occurs overnight. The following increase your risk of developing this painful problem:
Bone spurs in the heel can accompany plantar fasciitis, but are generally not the source of the pain. If you treat the plantar fasciitis appropriately, the bone spur is likely to no longer bother you.
Heel bursitis (inflammation of the back of the heel) can be caused by landing hard or awkwardly on the heel, or by pressure from shoes.
Achilles tendonitis is inflammation of the large tendon that connects your calf muscle to your heel. This can be caused by:
What to Expect at Your Office Visit
Diagnostic tests that may be performed include a foot x-ray, or diagnostic ultrasound focusing on the heel.
If either plantar fasciitis or bursitis is diagnosed and if shoe changes and the use of orthotics have not been successful, cortisone injections may be tried. Surgery is a last resort and is seldom necessary.
If Achilles tendonitis is diagnosed, anti-inflammatory medicine may be prescribed. Heel lifts may be used. Stretching can be helpful. In particularly unresponsive cases, a walking cast or boot may be helpful. Surgery is usually not necessary.
To prevent plantar fasciitis and Achilles tendonitis, maintain flexible and strong muscles in your calves, ankles, and feet. Always stretch and warm-up prior to athletic activities.
Wear comfortable, properly fitting shoes with good arch support and cushioning. If you pronate, look for athletic shoes with an antipronation device. If orthotics are prescribed by your provider, wear them in all of your shoes, not just while exercising.