Both Radiofrequency Microtenotomy and Physical Therapy Provide Significant Improvements in Patients With Chronic Midportion Achilles Tendinopathy at a Minimum 5-Year Follow-Up.

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 ( 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).