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哪种治疗方法在治疗慢性足底筋膜炎方面更好:皮质类固醇注射、体外冲击波疗法还是射频热疗?

Which Treatment Method Is Better in the Treatment of Chronic Plantar Fasciitis: Corticosteroid Injection, Extracorporeal Shock Wave Therapy, or Radiofrequency Thermal Lesioning?

机构信息

*Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, Turkey.

†Department of Physical Medicine and Rehabilitation, Giresun University Faculty of Medicine, Giresun, Turkey.

出版信息

J Am Podiatr Med Assoc. 2023 Sep-Oct;113(5). doi: 10.7547/21-049.

Abstract

BACKGROUND

Chronic plantar fasciitis (CPF) is a common disease that has various treatment options. This study aimed to compare the effectiveness of three of these options: corticosteroid injection (CSI), extracorporeal shock wave therapy (ESWT), and radiofrequency thermal lesioning (RTL).

METHODS

The records of 229 patients treated with CSI (n = 81), ESWT (n = 76), or RTL (n = 72) were retrospectively analyzed. Visual analog scale scores, patient satisfaction-related success rates, repeated treatment rates, and initial treatment change rates were compared.

RESULTS

Mean ± SD follow-up was 19.0 ± 4.5 months. Baseline clinical characteristics, mean visual analog scale scores (before treatment and at months 3, 6, and 12), patient satisfaction and success rates (at months 6 and 12), and repeated treatment and initial treatment change rates were similar between treatment groups. No complications were observed after the treatments.

CONCLUSIONS

All three options-CSI, ESWT, and RTL-were found to be safe and effective in treating CPF, with similar outcomes up to 1 year. Use of CSIs is advantageous because it is more accessible than the other treatments. Similarly, the noninvasive nature of ESWT is glaring among other minimally invasive options. Therefore, the first-line treatment modality of CPF can be CSI or ESWT, depending on the patient's and physician's joint preference; RTL treatment should be tried in patients who do not respond to these treatments.

摘要

背景

慢性足底筋膜炎(CPF)是一种常见疾病,有多种治疗选择。本研究旨在比较其中三种治疗方法的疗效:皮质类固醇注射(CSI)、体外冲击波疗法(ESWT)和射频热疗(RTL)。

方法

回顾性分析了 229 名接受 CSI(n=81)、ESWT(n=76)或 RTL(n=72)治疗的患者的记录。比较了视觉模拟评分、与患者满意度相关的成功率、重复治疗率和初始治疗变化率。

结果

平均随访时间为 19.0±4.5 个月。治疗组之间基线临床特征、平均视觉模拟评分(治疗前、治疗后 3、6 和 12 个月)、患者满意度和成功率(治疗后 6 和 12 个月)以及重复治疗和初始治疗变化率相似。治疗后均未观察到并发症。

结论

CSI、ESWT 和 RTL 三种治疗方法均被发现安全有效,治疗 CPF 的效果相似,1 年内结果相似。CSI 的优势在于其比其他治疗方法更容易获得。同样,ESWT 的非侵入性在其他微创选择中也很明显。因此,CPF 的一线治疗方法可以是 CSI 或 ESWT,取决于患者和医生的共同偏好;对于这些治疗方法无反应的患者,可以尝试 RTL 治疗。

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