Radiofrequency Ablation for Interdigital Neuroma: Moderate 2-Year Outcomes and Surgical Conversion Rate.

Abstract

Background: Radiofrequency ablation (RFA) has emerged as a minimally invasive alternative for the treatment of interdigital neuroma; however, evidence regarding its midterm effectiveness remains limited. The aim of this study was to evaluate midterm clinical outcomes following RFA, focusing on pain relief, functional improvement, and the need for subsequent surgery.

Methods: A retrospective observational study was conducted including patients with a single symptomatic interdigital neuroma treated with RFA between January 2019 and January 2024. Patients with multiple or bilateral neuromas were excluded. Clinical outcomes were assessed at a minimum follow-up of 2 years using the visual analog scale (VAS) and the Manchester-Oxford Foot Questionnaire (MOXFQ). A clinically meaningful improvement was defined as a reduction of ≥3 points in VAS.

Results: Sixty-three patients were included. A clinically meaningful reduction in VAS was achieved in 65.2% of patients. MOXFQ scores improved (P < .001 for all domains) across all domains, exceeding the minimal clinically important change in pain and function subscales. However, 27.0% of patients ultimately required surgical treatment. No significant predictors of clinical response were identified.

Conclusion: RFA was associated with moderate pain and functional improvement in selected patients with interdigital neuroma. Although approximately one-quarter of patients ultimately required surgical treatment, postoperative outcomes remained favorable, supporting RFA as a reasonable intermediate treatment option for appropriately selected patients. These findings highlight the need for careful patient selection, realistic preoperative counseling, and further comparative studies with alternative surgical techniques.

Level of evidence: Level IV, therapeutic study.