Both Radiofrequency Microtenotomy and Physical Therapy Provide Significant Improvements in Patients With Chronic Midportion Achilles Tendinopathy at a Minimum 5-Year Follow-Up
In brief
Radiofrequency microtenotomy cuts chronic Achilles pain to near zero and beats physical therapy after five years
In a 5-year follow-up of 25 patients, both radiofrequency microtenotomy and structured physical therapy markedly lowered pain scores, but the microtenotomy group fell to an average pain rating of 0.3 versus 2.2 with therapy and reported better quality of life. The findings are limited by modest sample size and loss to follow-up, so larger trials are needed.
- Journal
- Arthroscopy, sports medicine, and rehabilitation (Q1)
- Published
- 2 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Hayat Jirde Ali, Khaled Meknas, Jüri-Toomas Kartus, Dana Meknas
- PMID
- 42694235
- DOI
- 10.1002/ars2.70061
Why clinicians should know about it
- Picked for Orthopedics and Sports Medicine (paper of the day, 7 September 2026): RFM vs PT improves chronic Achilles tendinopathy long-term
Abstract
PURPOSE: To evaluate a minimum 5-year follow-up of patients who were treated with either bipolar radiofrequency microtenotomy (RFM) or physical therapy (PT) for midportion Achilles tendinopathy between 2016 and 2018. METHODS: All subjects who participated in a previous randomized controlled trial (n = 38) between 2016 and 2018 were invited to fill out a questionnaire between January and July 2025 to evaluate the outcomes at a minimum of 5-year follow-up. Patients who had undergone further surgical treatment were excluded. Visual analog scale (VAS) for pain and Foot and Ankle Outcome Score (FAOS) were used to assess clinical outcomes. RESULTS: A total of 25 out of the 38 (66%) invited subjects were included: 13 (65%) in the RFM group and 12 (67%) in the PT group. Both treatment groups had significantly improved VAS at the minimum 5-year follow-up compared with preintervention. The RFM group improved from 7.3 ± 1.2 to 0.3 ± 0.8 (P = .002), whereas the PT group improved from 5.7 ± 0.3 to 2.2 ± 2.6 (P = .010). The RFM group had significantly better VAS than the PT group at the minimum 5-year follow-up (P = .019). All parameters in the FAOS were significantly improved for patients in both the RFM group and the PT group. Quality of life was the only variable of the FAOS with significantly better results for RFM in comparison with PT (P = .047). CONCLUSIONS: In this study, patients with chronic midportion Achilles tendinopathy reported significant improvements in VAS and FAOS 6 to 9 years after intervention with either RFM or PT. The RFM group reported significantly better outcomes in VAS and quality of life. However, because of loss to follow-up, the study is underpowered, and the results should be interpreted with caution. LEVEL OF EVIDENCE: Level II, therapeutic, poor-quality randomized controlled trial (<80% f/u).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.