Colberg Ricardo E, Kenneth-Nwosa Ken O, Jurado Vélez Javier A, Slowik Jonathan S, Fleisig Glenn S
Andrew's Sports Medicine and Orthopedic Center, Pelham, AL, USA.
American Sports Medicine Institute, Birmingham, AL, USA.
Foot Ankle Orthop. 2022 Apr 23;7(2):24730114221091797. doi: 10.1177/24730114221091797. eCollection 2022 Apr.
A plantar fasciotomy using a microdebrider coblation wand may be an effective treatment for treating chronic plantar fasciitis. The objective of this prospective study was to determine the success rate of performing a plantar fasciotomy using a microdebrider coblation wand to treat plantar fasciitis and determine utility of ultrasonographic imaging to evaluate for recovery after treatment.
Patients with plantar fasciitis treated with a plantar fasciotomy using a microdebrider coblation wand were prospectively followed for 1 year. Outcome measures included numeric rating scale (NRS) for pain, Foot and Ankle Disability Index (FADI), the Foot and Ankle Ability Measure for activities of daily living (FAAMA) and for sports (FAAMS), and plantar fascia thickness evaluated with ultrasonographic imaging.
Forty patients were included. Average patient age was 53.4 ± 9.9 years. Average symptom duration prior to the procedure was 20 ± 26 months. Five patients dropped out of the study at various points, most due to the COVID quarantine. The mean preoperative NRS score was 4.7 and at 3 and 6 months postprocedure was ≤2. At 1 year, the outcomes were all improved compared to the preoperative status: NRS 0.7±1.3 ( < .001), FADI 107±16 ( < .001), FAAMA 95%±10% ( < .001), FAAMS 84%±19% ( < .001), and plantar fascia thickness 6.8 ± 1.2 mm ( = .014). Furthermore, 86% of patients had clinically successful outcome in pain, defined as NRS score ≤ 2 (95% CI 0, 2), and 91% of patients had a clinically successful outcome in their function, defined as having an FAAMA score ≥75%. There were no complications at the operative site either during or after the procedure.
In this study of 40 patients followed prospectively, we found percutaneous plantar fasciotomy using a microdebrider coblation wand to be an effective treatment for plantar fasciitis, with a low incidence of complications. Ultrasonographic imaging may help evaluate for interval healing. Level IV, prospective case series.
使用微清创消融棒进行足底筋膜切开术可能是治疗慢性足底筋膜炎的有效方法。这项前瞻性研究的目的是确定使用微清创消融棒进行足底筋膜切开术治疗足底筋膜炎的成功率，并确定超声成像在评估治疗后恢复情况方面的实用性。
对使用微清创消融棒进行足底筋膜切开术治疗的足底筋膜炎患者进行为期1年的前瞻性随访。结果指标包括疼痛数字评分量表（NRS）、足踝残疾指数（FADI）、日常生活活动能力的足踝能力测量量表（FAAMA）和运动能力的足踝能力测量量表（FAAMS），以及通过超声成像评估的足底筋膜厚度。
纳入40例患者。患者平均年龄为53.4±9.9岁。术前平均症状持续时间为20±26个月。5例患者在不同时间点退出研究，大多数是由于新冠疫情隔离。术前NRS平均评分为4.7，术后3个月和6个月时≤2。在1年时，与术前状态相比，所有结果均有改善：NRS为0.7±1.3（P<0.001），FADI为107±16（P<0.001），FAAMA为95%±10%（P<0.001），FAAMS为84%±19%（P<0.001），足底筋膜厚度为6.8±1.2mm（P=0.014）。此外，86%的患者在疼痛方面临床治疗成功，定义为NRS评分≤2（95%CI为0，2），91%的患者在功能方面临床治疗成功，定义为FAAMA评分≥75%。手术过程中及术后手术部位均无并发症发生。
在这项对40例患者进行前瞻性随访的研究中，我们发现使用微清创消融棒进行经皮足底筋膜切开术是治疗足底筋膜炎的有效方法，并发症发生率低。超声成像可能有助于评估愈合情况。IV级，前瞻性病例系列研究。
