Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil.
Department of Orthopaedics and Traumatology, Prevent Senior, São Paulo, Brazil.
Foot Ankle Surg. 2022 Oct;28(7):879-882. doi: 10.1016/j.fas.2021.12.004. Epub 2021 Dec 8.
Heel pain is a common condition and often involves the Achilles tendon and is classified as insertional or non-insertional. Several operative and non-operative treatments have been described, but there is no consensus on the most effective therapy. The aim of this study is to evaluate a case series of patients with insertional Achilles tendinopathy refractory to conservative treatment submitted to a single-dose ultrasound-guided injection of hyaluronic acid (40 mg/2.0 mL).
We prospectively included 25 patients (29 feet) who underwent a single ultrasound-guided injection of hyaluronic acid after conservative treatment failure. Clinical outcomes such as pain (using the Visual Analog Scale - VAS), function (using the American Orthopedic Foot & Ankle Society - AOFAS score), personal satisfaction, and complications were evaluated. Statistical analysis was performed using the R software.
Most patients were female (80%) and there was a right-side predominance (55%). The median VAS was 8 points [range 4-10] at baseline, decreasing to 3 points [range 0-8] at the six-month follow-up, with statistical significance (p < .001). The median AOFAS score was 71 points [range 38-87] at baseline, increasing to 90 points [range 48-100] at the six-month follow-up (p < .001). The personal satisfaction level was 69%, and 48% of patients considered the result excellent. There were no Achilles tendon ruptures, infections, or allergic reactions post injection.
Single-dose injection of hyaluronic acid is a safe treatment option, improving function and reducing pain for six months in patients with insertional Achilles tendinopathy after conservative treatment failure.
IV, case series.
足跟痛是一种常见病症，通常涉及跟腱，可分为附着点或非附着点病变。已经描述了几种手术和非手术治疗方法，但对于最有效的治疗方法尚未达成共识。本研究旨在评估一组经保守治疗失败的附着性跟腱病患者的病例系列，这些患者接受了单次超声引导下透明质酸（40mg/2.0mL）注射治疗。
我们前瞻性纳入了 25 例（29 只脚）经保守治疗失败后接受单次超声引导下透明质酸注射的患者。评估了疼痛（采用视觉模拟评分法-VAS）、功能（采用美国矫形足踝协会-AOFAS 评分）、个人满意度和并发症等临床结果。统计分析采用 R 软件进行。
大多数患者为女性（80%），且右侧优势（55%）更为明显。基线时 VAS 中位数为 8 分[范围 4-10]，6 个月随访时降至 3 分[范围 0-8]，差异具有统计学意义（p<0.001）。基线时 AOFAS 评分为 71 分[范围 38-87]，6 个月随访时增至 90 分[范围 48-100]，差异具有统计学意义（p<0.001）。个人满意度为 69%，48%的患者认为疗效极佳。注射后无跟腱断裂、感染或过敏反应发生。
对于经保守治疗失败的附着性跟腱病患者，单次透明质酸注射是一种安全的治疗选择，可在 6 个月时改善功能并减轻疼痛。
IV，病例系列研究。
