Comparative Effectiveness of Ultrasound-Guided Corticosteroid Injection, Radiofrequency Ablation, and Their Combination for Recalcitrant Plantar Fasciitis: A Retrospective Cohort Study.

IF 2.2 3区 医学 Q1 ORTHOPEDICS
Çile Aktan, Cemil Aktan
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引用次数: 0

Abstract

Background: Recalcitrant plantar fasciitis (PF) refers to persistent heel pain lasting ≥ 6 months despite appropriate conservative management, including physical therapy, orthotics, and pharmacological interventions. This study aimed to compare the clinical efficacy and safety of corticosteroid injection (CI), radiofrequency ablation (RFA), and their combination in patients with recalcitrant PF.

Methods: In this retrospective study, a total of 156 patients with ultrasonographically confirmed plantar fasciitis, experiencing heel pain for at least 6 months and unresponsive to ≥ 3 months of standard conservative therapy, were included; 52 received RFA, 50 received CI, and 54 underwent combined therapy. Pain intensity (visual analog scale [VAS]), functional status (Foot Function Index [FFI], Roles and Maudsley score [RMS]), plantar fascia thickness (PFT), and relapse rates at 12 months were assessed. Within-group and between-group differences were assessed using appropriate nonparametric tests, and relapse rates were compared accordingly.

Results: All treatment modalities improved VAS, FFI, RMS, and PFT at 6 months (p < 0.001). VAS declined from 6.73 to 6.81 at baseline to 1.62 in the RFA group and 1.83 in the combined group, whereas remaining at 6.56 in the CI group. FFI dropped from ∼52 to 21.50 and 17.57 in the RFA and combined groups but remained at 46.62 in the CI. PFT decreased from ∼6.2 mm to 3.29, 2.71, and 2.95 mm, respectively. Relapse occurred in 12 (23.1%), 19 (38.0%), and 8 (14.8%) patients in the RFA, CI, and combined groups. Between-group differences were significant at 6 months (p < 0.001). No major adverse events were observed.

Conclusion: Both CI and RFA are effective in recalcitrant PF, but their combination provides superior and more durable improvements in pain, function, and fascia morphology, with the lowest relapse rates. Ultrasound-guided combined therapy suggests a safe, practical, and effective treatment option for patients unresponsive to conservative measures.

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超声引导下皮质类固醇注射、射频消融及其联合治疗顽固性足底筋膜炎的比较疗效:一项回顾性队列研究。
背景:顽固性足底筋膜炎(PF)是指尽管采取了适当的保守治疗,包括物理治疗、矫形器和药物干预,但持续性足跟疼痛持续≥6个月。本研究旨在比较皮质类固醇注射(CI)、射频消融(RFA)及其联合治疗顽固性足底筋膜炎患者的临床疗效和安全性。方法:本回顾性研究共纳入156例超声确诊足底筋膜炎患者,患者足跟疼痛持续至少6个月,对≥3个月的标准保守治疗无反应;RFA 52例,CI 50例,联合治疗54例。评估疼痛强度(视觉模拟量表[VAS])、功能状态(足功能指数[FFI]、Roles和Maudsley评分[RMS])、足底筋膜厚度(PFT)和12个月的复发率。使用适当的非参数测试评估组内和组间差异,并相应地比较复发率。结果:所有治疗方式均改善了6个月时的VAS、FFI、RMS和PFT (p)。结论:CI和RFA对顽固性PF均有效,但其联合治疗在疼痛、功能和筋膜形态方面提供了更持久的改善,复发率最低。超声引导联合治疗对保守治疗无效的患者是一种安全、实用、有效的治疗选择。
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来源期刊
CiteScore
4.50
自引率
10.30%
发文量
83
审稿时长
>12 weeks
期刊介绍: Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.
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