Comparison of Radiofrequency Ablation and Steroid Injection in the Treatment of Plantar Fasciitis; Short and Medium Term Results
Öz
Objective: Plantar fasciitis, commonly found in orthopaedic practice, may restrict daily life activities and lead to loss of workforce. We aimed to evaluate the short- and medium-term outcomes of radiofrequency ablation (RFA) and steroid injection treatments in patients with plantar fasciitis who did not benefit from conservative therapies through pain and function scores.
Material and Method: Patients studied at the Hakkari State Hospital for at least six months of conservative treatment due to plantar fasciitis between 01.07.2021-01.01.2023. The patients were divided into two groups: those who received RFA and those who were given steroid injections. Demographic information of the patients, the Visual Analog Scale (VAS) and the American Orthopedic Foot Ankle Society (AOFAS) score were studied, and both gups were compared.
Results: No significant difference was observed when comparing preop VAS and AOFAS values for both groups (p=0.469 p=0.244). No significant difference was observed when comparing the VAS and AOFAS values of the two groups for the first month (p=0.764 p=0.466 respectively). A significant difference was observed when comparing the VAS and AOFAS values in the post-6 month (p=0,001 p=0.001). Significant differences were observed between VAS and AOFAS values in patients receiving RFA in preop and 6 months (p=0.001 p=0.001). No significant difference was observed in preop and 6 month VAS and AOFAS values in steroid injections (p=0.512 p=0.844 respectively).No complications were observed in both groups during the follow-up period.
Conclusion: In patients who have received conservative treatment but have not benefited, radiofrequency ablation has been found to be an effective, safe and minimally invasive method of reducing the severity of pain in the short to medium term and improving daily activities.
Anahtar Kelimeler
Plantar Fasciitis Radiofrequency Ablation Steroid Injection Calcaneal Spur
Kaynakça
- Thomas JL, Christensen JC, Kravitz SR, Mendicino RW, Schuberth JM, Vanore JV, et al. The diagnosis and treatment of heel pain: a clinical practice guideline–revision 2010. J Foot Ankle Surg 2010;49(3):1-19.
- Gülcan E, Aksakallı E, Akman B. Kalkaneal Spur'un (topuk dikeni) lokal kortikosteroid ve anestezik madde enjeksiyonu ile tedavisinin erken ve orta dönem sonuçlar. Medeni Med J 2008;23(2):59-62.
- Ozdemir H, Ozdemir A, Bilbaşar H, Akyıldız F. Topuk ağrısında non-invazif konservatif tedavi sonuçları ve epin kalkaneinin topuk ağrısındaki rolü. Jt Dis Relat Surg 2002;13(4):247-55.
- Alshami AM, Souvlis T, Coppieters MW. A review of plantar heel pain of neural origin: differential diagnosis and management. Man Ther 2008;13(2):103-11.
- Thapa D, Ahuja V. Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: a new modality. Indian J Anaesth 2014;58(2):183-7.
- Prichasuk S, Subhadrabandhu T. The relationship of pes planus and calcaneal spur to plantar heel pain. Clin Orthop Relat Res 1994(306):192-6.
- Johal K, Milner S. Plantar fasciitis and the calcaneal spur: fact or fiction? Foot Ankle Surg (NY) 2012;18(1):39-41.
- Aygün H, Yaray O. Radyofrekansın kas iskelet sistemi hastalıklarında kullanımı. TOTBID Dergisi 2017; 16:230–237
- Rozen G, Ptaszek L, Zilberman I, Cordaro K, Heist EK, Beeckler C, et al. Prediction of radiofrequency ablation lesion formation using a novel temperature sensing technology incorporated in a force sensing catheter. Heart Rhythm 2017;14(2):248-54.
- Meknas K, Odden-Miland Å, Mercer JB, Castillejo M, Johansen O. Radiofrequency microtenotomy: a promising method for treatment of recalcitrant lateral epicondylitis. Am J Sports Med 2008;36(10):1960-5.
- Eke I, Akcal MA, Sayrac AV, Iyetin Y. Effects of intralesional pulsed radiofrequency treatment on pain in patients with calcaneal spur: results of 460 patients. BMC Musculoskelet Disord 2021;22(1):1-8.
- Yürük D, Karlıbel İA, Aksoy MK. The effectiveness of conventional radiofrequency ablation for chronic plantar heel pain due to heel spur. Agri 2021;34(2):131-138.
- Kane RL, Bershadsky B, Rockwood T, Saleh K, Islam NCJJoce. Visual Analog Scale pain reporting was standardized. 2005;58(6):618-23.
- Rastegar S, Baradaran Mahdavi S, Hoseinzadeh B, Badiei S. Comparison of dry needling and steroid injection in the treatment of plantar fasciitis: a single-blind randomized clinical trial. International orthopaedics. 2018;42:109-16.
- Singh P, Madanipour S, Bhamra JS, Gill I. A systematic review and meta-analysis of platelet-rich plasma versus corticosteroid injections for plantar fasciopathy. International orthopaedics. 2017;41:1169-81.
- Zhang H, Xiao T. Comment on Singh et al.: A systematic review and meta-analysis of platelet-rich plasma versus corticosteroid injections for plantar fasciopathy. International Orthopaedics. 2018;42:219-20.
- David JA, Sankarapandian V, Christopher PR, Chatterjee A, Macaden ASJCDoSR. Injected corticosteroids for treating plantar heel pain in adults. 2017(6).
- Cole C, Seto C, Gazewood J. Plantar fasciitis: evidence-based review of diagnosis and therapy. American family physician. 2005;72(11):2237-42.
- Davies MS, Weiss GA, Saxby TS. Plantar fasciitis: how successful is surgical intervention? Foot & ankle international. 1999;20(12):803-7.
- Yapici F, Gur V, Sari IF, Karakose R, Tardus I, Ucpunar H. Which Treatment Method Is Better in the Treatment of Chronic Plantar Fasciitis: Corticosteroid Injection, Extracorporeal Shock Wave Therapy, or Radiofrequency Thermal Lesioning? J Am Podiatr Med Assoc. 2023;113(5).
Plantar Fasiit Tedavisinde Radyofrekans Ablasyon ve Steroid Enjeksiyonu Etkinliğinin Karşılaştırılması; Kısa ve Orta Dönem Sonuçları
Öz
Amaç: Ortopedi pratiğinde oldukça sık rastlanan plantar fasiit günlük yaşam aktivitelerini kısıtlayabilmekte ve iş gücü kaybına neden olabilmektedir. Konservatif tedavilerden fayda görmeyen plantar fasiitli hastalarda radyofrekans ablasyon(RFA) ve steroid enjeksiyonu tedavilerinin kısa ve orta dönem sonuçlarını ağrı ve fonksiyon skorları üzerinden değerlendirmeyi hedefledik.
Gereç ve Yöntem: Hakkari Devlet Hastanesi’ne 01.07.2021-01.01.2023 tarihleri arasında plantar fasiit nedeniyle en az altı ay konservatif tedaviler yapılan ancak fayda görmeyen hastalar incelendi. Hastalar RFA uygulananlar ve steroid enjeksiyonu uygulananlar olmak üzere iki gruba ayrıldı. Hastaların demografik bilgileri, Görsel Analog Skala(VAS) ve Amerikan Ortopedik Ayak-Ayak bileği Derneği skoru (AOFAS) incelendi ve her iki gup birbiriyle karşılaştırıldı.
Bulgular: Her iki grubun preop VAS ve AOFAS değerleri karşılaştırıldığında anlamlı farklılık izlenmedi (Sırasıyla p=0,469 p=0,244). Her iki grubun postop 1. ay VAS ve AOFAS değerleri karşılaştırıldığında anlamlı farklılık izlenmedi (Sırasıyla p=0,764 p=0,466). Postop 6. ay VAS ve AOFAS değerleri karşılaştırıldığında anlamlı farklılık olduğu görüldü (Sırasıyla p=0,001 p=0,001). RFA yapılan hastaların preop ve 6.aylardaki VAS ve AOFAS değerleri arasında anlamlı farklılık olduğu görüldü (Sırasıyla p=0,001 p=0,001). Steroid enjeksiyonu yapılan hastaların preop ve 6.ay VAS ve AOFAS değerleri açısından anlamlı farklılık olmadığı izlendi (Sırasıyla p=0,512 p=0,844).Her iki grupta da takip süresi boyunca komplikasyon izlenmedi.
Sonuç: Araştırmamızın sonuçlarına göre konservatif tedavi görmüş ancak fayda görememiş olan hastalarda, radyofrekans ablasyon uygulamasının kısa ve orta dönemde ağrı şiddetini azaltma ve günlük aktiviteleri iyileştirme konularında etkili, güvenli ve minimal invaziv bir yöntem olduğu tespit edilmiştir.
Anahtar Kelimeler
Plantar Fasiit Radyofrekans Ablasyon Steroid Enjeksiyon Kalkaneal Spur
Kaynakça
- Thomas JL, Christensen JC, Kravitz SR, Mendicino RW, Schuberth JM, Vanore JV, et al. The diagnosis and treatment of heel pain: a clinical practice guideline–revision 2010. J Foot Ankle Surg 2010;49(3):1-19.
- Gülcan E, Aksakallı E, Akman B. Kalkaneal Spur'un (topuk dikeni) lokal kortikosteroid ve anestezik madde enjeksiyonu ile tedavisinin erken ve orta dönem sonuçlar. Medeni Med J 2008;23(2):59-62.
- Ozdemir H, Ozdemir A, Bilbaşar H, Akyıldız F. Topuk ağrısında non-invazif konservatif tedavi sonuçları ve epin kalkaneinin topuk ağrısındaki rolü. Jt Dis Relat Surg 2002;13(4):247-55.
- Alshami AM, Souvlis T, Coppieters MW. A review of plantar heel pain of neural origin: differential diagnosis and management. Man Ther 2008;13(2):103-11.
- Thapa D, Ahuja V. Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: a new modality. Indian J Anaesth 2014;58(2):183-7.
- Prichasuk S, Subhadrabandhu T. The relationship of pes planus and calcaneal spur to plantar heel pain. Clin Orthop Relat Res 1994(306):192-6.
- Johal K, Milner S. Plantar fasciitis and the calcaneal spur: fact or fiction? Foot Ankle Surg (NY) 2012;18(1):39-41.
- Aygün H, Yaray O. Radyofrekansın kas iskelet sistemi hastalıklarında kullanımı. TOTBID Dergisi 2017; 16:230–237
- Rozen G, Ptaszek L, Zilberman I, Cordaro K, Heist EK, Beeckler C, et al. Prediction of radiofrequency ablation lesion formation using a novel temperature sensing technology incorporated in a force sensing catheter. Heart Rhythm 2017;14(2):248-54.
- Meknas K, Odden-Miland Å, Mercer JB, Castillejo M, Johansen O. Radiofrequency microtenotomy: a promising method for treatment of recalcitrant lateral epicondylitis. Am J Sports Med 2008;36(10):1960-5.
- Eke I, Akcal MA, Sayrac AV, Iyetin Y. Effects of intralesional pulsed radiofrequency treatment on pain in patients with calcaneal spur: results of 460 patients. BMC Musculoskelet Disord 2021;22(1):1-8.
- Yürük D, Karlıbel İA, Aksoy MK. The effectiveness of conventional radiofrequency ablation for chronic plantar heel pain due to heel spur. Agri 2021;34(2):131-138.
- Kane RL, Bershadsky B, Rockwood T, Saleh K, Islam NCJJoce. Visual Analog Scale pain reporting was standardized. 2005;58(6):618-23.
- Rastegar S, Baradaran Mahdavi S, Hoseinzadeh B, Badiei S. Comparison of dry needling and steroid injection in the treatment of plantar fasciitis: a single-blind randomized clinical trial. International orthopaedics. 2018;42:109-16.
- Singh P, Madanipour S, Bhamra JS, Gill I. A systematic review and meta-analysis of platelet-rich plasma versus corticosteroid injections for plantar fasciopathy. International orthopaedics. 2017;41:1169-81.
- Zhang H, Xiao T. Comment on Singh et al.: A systematic review and meta-analysis of platelet-rich plasma versus corticosteroid injections for plantar fasciopathy. International Orthopaedics. 2018;42:219-20.
- David JA, Sankarapandian V, Christopher PR, Chatterjee A, Macaden ASJCDoSR. Injected corticosteroids for treating plantar heel pain in adults. 2017(6).
- Cole C, Seto C, Gazewood J. Plantar fasciitis: evidence-based review of diagnosis and therapy. American family physician. 2005;72(11):2237-42.
- Davies MS, Weiss GA, Saxby TS. Plantar fasciitis: how successful is surgical intervention? Foot & ankle international. 1999;20(12):803-7.
- Yapici F, Gur V, Sari IF, Karakose R, Tardus I, Ucpunar H. Which Treatment Method Is Better in the Treatment of Chronic Plantar Fasciitis: Corticosteroid Injection, Extracorporeal Shock Wave Therapy, or Radiofrequency Thermal Lesioning? J Am Podiatr Med Assoc. 2023;113(5).
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Ortopedi |
| Bölüm | Original Article |
| Yazarlar | |
| Erken Görünüm Tarihi | 27 Nisan 2024 |
| Yayımlanma Tarihi | 30 Nisan 2024 |
| Gönderilme Tarihi | 30 Kasım 2023 |
| Kabul Tarihi | 20 Şubat 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 34 Sayı: 2 |
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