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跟骨骨刺患者足底筋膜炎的治疗:射频热消融还是体外冲击波疗法?

Treatment of Plantar Fasciitis in Patients with Calcaneal Spurs: Radiofrequency Thermal Ablation or Extracorporeal Shock Wave Therapy?

作者信息

Tas Nevsun Pihtili, Kaya Oğuz

机构信息

Department of Physical Medicine and Rehabilitation, Health Sciences University Elazig Fethi Sekin City Hospital, Elazıg 23280, Turkey.

Department of Orthopedics and Traumatology, Elazig Fethi Sekin City Hospital, Elazıg 23280, Turkey.

出版信息

J Clin Med. 2023 Oct 13;12(20):6503. doi: 10.3390/jcm12206503.

Abstract

BACKGROUND AND OBJECTIVES

We aimed to compare the effectiveness of ESWT (Extracorporeal Shock Wave Therapy) and RFA (Radiofrequency Thermal Ablation) on pain, disability, and activity limitation in the treatment of plantar fasciitis in patients with calcaneal spurs.

MATERIALS AND METHODS

Patients who apply to Orthopedics and Traumatology and Physical Medicine and Rehabilitation departments with a complaint of heel pain are included in this retrospective study. We included patients diagnosed with calcaneal spurs who received treatment with ESWT ( = 80) and RFA ( = 79) between 1 August 2021 and 1 September 2022. All patients were evaluated using the Visual Analog Scale (VAS), Foot Function Index (FFI), and the Roles and Maudsley score (RM) before and after treatment. An evaluation was performed on average 6 months after treatment.

RESULTS

This study included 79 RFA patients (34 females and 45 males) with a mean age of 55.8 ± 9.6 years and 80 ESWT patients (20 females and 60 males) with a mean age of 49.1 ± 9.5 years. There was a significant decrease in VAS scores after treatment in both the RFA and ESWT groups (z: -4.98, z: -5.18, respectively, < 0.001). The reductions in FFI pain, FFI activity restriction, FFI disability, and RM scores were significant in both groups, although the scores after treatment were lower in the RFA group.

CONCLUSIONS

This study demonstrates that ESWT and RFA significantly reduced pain, disability, and activity restriction in the treatment of plantar fasciitis in patients with calcaneal spurs. ESWT proved particularly effective in alleviating pain, whereas RFA had more pronounced effects on reducing disability and activity limitations. The choice of treatment should be based on the patient's specific complaints.

摘要

背景与目的

我们旨在比较体外冲击波疗法(ESWT)和射频热消融术(RFA)在治疗跟骨骨刺患者足底筋膜炎时对疼痛、功能障碍及活动受限情况的疗效。

材料与方法

本回顾性研究纳入了因足跟疼痛而就诊于骨科、创伤科以及物理医学与康复科的患者。我们纳入了2021年8月1日至2022年9月1日期间被诊断为跟骨骨刺并接受ESWT治疗(n = 80)和RFA治疗(n = 79)的患者。所有患者在治疗前后均使用视觉模拟量表(VAS)、足部功能指数(FFI)以及罗尔斯和莫兹利评分(RM)进行评估。治疗后平均6个月进行一次评估。

结果

本研究纳入了79例RFA患者(34例女性和45例男性),平均年龄为55.8±9.6岁,以及80例ESWT患者(20例女性和60例男性),平均年龄为49.1±9.5岁。RFA组和ESWT组治疗后VAS评分均显著降低(z值分别为 -4.98和 -5.18,P < 0.001)。两组患者的FFI疼痛、FFI活动受限、FFI功能障碍及RM评分均显著降低,尽管RFA组治疗后的评分更低。

结论

本研究表明,ESWT和RFA在治疗跟骨骨刺患者足底筋膜炎时能显著减轻疼痛、功能障碍及活动受限。ESWT在缓解疼痛方面特别有效,而RFA在减少功能障碍和活动受限方面效果更显著。治疗方法的选择应基于患者的具体症状。

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Effectiveness of radiofrequency ablation for treatment of plantar fasciitis.射频消融治疗足底筋膜炎的疗效。
Medicine (Baltimore). 2022 Mar 25;101(12):e29142. doi: 10.1097/MD.0000000000029142.
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The age dependent change in the incidence of calcaneal spur.跟骨骨刺发病率随年龄的变化。
Acta Orthop Traumatol Turc. 2018 Sep;52(5):367-371. doi: 10.1016/j.aott.2018.06.013. Epub 2018 Aug 28.

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