足底筋膜炎的手术治疗选择及其疗效：系统评价和网络荟萃分析。
Surgical treatment options for plantar fasciitis and their effectiveness: a systematic review and network meta-analysis.
机构信息
Department of Trauma and Orthopaedic Surgery, Barking, Havering and Redbridge University Hospitals NHS Trust, Queen's Hospital, Rom Valley Way, Romford, RM7 0AG, UK.
出版信息
Arch Orthop Trauma Surg. 2023 Aug;143(8):4641-4651. doi: 10.1007/s00402-022-04739-0. Epub 2023 Jan 3.
BACKGROUND
To date, there are no systematic reviews on the utility of surgical management for plantar fasciitis to guide best practice. This review aimed to evaluate the operative options for plantar fasciitis and their effectiveness.
METHODS
A systematic review and network meta-analysis were carried out in accordance with PRISMA guidelines. A search strategy was conducted on the MEDLINE, EMBASE, and Cochrane databases. Quality was assessed using the ROBINS-I tool.
RESULTS
17 studies involving 865 patients were included. Surgical options considered were open and endoscopic plantar fasciotomy, gastrocnemius release, radiofrequency microtenotomy and dry needling. All interventions resulted in improvement in VAS and AOFAS scores. No major complications were seen from any treatment modality.
CONCLUSIONS
Surgical interventions are effective in providing short- to medium-term symptomatic relief for plantar fasciitis refractory to non-operative management. Current evidence is equivocal regarding treatment choice. Further large randomised studies are required to establish long-term outcomes and a management algorithm.
LEVEL OF EVIDENCE
Level III.
背景
迄今为止，尚无系统评价探讨足底筋膜炎的手术治疗方法，以指导最佳实践。本研究旨在评估足底筋膜炎的手术治疗选择及其疗效。
方法
按照 PRISMA 指南进行系统评价和网络荟萃分析。在 MEDLINE、EMBASE 和 Cochrane 数据库中进行检索策略。使用 ROBINS-I 工具评估质量。
结果
纳入 17 项研究，共 865 例患者。考虑的手术方案包括开放性和内镜下足底筋膜炎切开术、腓肠肌松解术、射频微切开术和干针松解术。所有干预措施均能改善 VAS 和 AOFAS 评分。任何治疗方式均未见严重并发症。
结论
对于经非手术治疗无效的足底筋膜炎，手术干预可有效提供短期至中期的症状缓解。目前尚不清楚哪种治疗方法更优。需要进一步开展大型随机研究以确定长期结局和治疗方案。
证据等级
III 级。
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