1
|
Ryu SC, Lee DO, Park Y, Shin Y, Lee DY, Kyung MG. Clinical Efficacy of Application-Linked Stretching Ball as Digital Therapeutics in Plantar Fasciitis. J Clin Med 2024; 13:2722. [PMID: 38731253 PMCID: PMC11084766 DOI: 10.3390/jcm13092722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024] Open
Abstract
Background/Objectives: This study aimed to evaluate the efficacy of application-linked stretching ball instruments that record the rolling time and force of patients compared with a traditional simple stretching ball. Methods: Fourteen participants with plantar fasciitis were divided into a simple massage ball group (group A, n = 8) and an application-linked massage ball group (group B, n = 6). The application-linked massage ball sends information regarding the massages, such as the frequency and force of the massage on the foot, to the application on the patient's smartphone. All clinical outcomes were evaluated at the beginning of the study and 1-, 2-, and 3-month follow-up. The primary outcome measure was the Manchester-Oxford Foot Questionnaire (MOXFQ) score. Results: At the beginning of the study, the initial MOXFQ score was not significantly different between the two groups (p = 0.948). At each time point, the MOXFQ score of the whole population did not improve significantly compared to that of the initial state (p = 0.131). Generalized estimating equation modeling demonstrated that there was no significant difference in the improvement of the MOXFQ score between groups A and B during follow-up (p = 0.826). In addition, no group-by-time interactions were observed (p = 0.457). Conclusions: The efficacy of an application-linked massage ball for the treatment of plantar fasciitis was not as definite as that of a traditional simple stretching ball in patients whose symptoms persisted for at least six months. Future studies that include patients with acute plantar fasciitis are required.
Collapse
Affiliation(s)
- Seok Chang Ryu
- BioRobotics Laboratory, Division of Mechanical and Biomedical Engineering, Ewha Womans University, Seoul 03760, Republic of Korea;
| | - Dong-Oh Lee
- Department of Orthopedic Surgery, SNU Seoul Hospital, Seoul 08703, Republic of Korea
| | - Yoojin Park
- Graduate Program in Smart Factory, Division of Mechanical and Biomedical Engineering, Ewha Womans University, Seoul 03760, Republic of Korea; (Y.P.); (Y.S.)
| | - Yujeong Shin
- Graduate Program in Smart Factory, Division of Mechanical and Biomedical Engineering, Ewha Womans University, Seoul 03760, Republic of Korea; (Y.P.); (Y.S.)
| | - Dong Yeon Lee
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul 03080, Republic of Korea;
| | - Min Gyu Kyung
- Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea
| |
Collapse
|
2
|
Daher M, Covarrubias O, Herber A, Oh I, Gianakos AL. Platelet-Rich Plasma vs Extracorporeal Shock Wave Therapy in the Treatment of Plantar Fasciitis at 3-6 Months: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Foot Ankle Int 2024:10711007241231959. [PMID: 38419209 DOI: 10.1177/10711007241231959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND Plantar fasciitis (PF) is a common foot disorder with variability in treatment strategy. Two effective management techniques include platelet-rich plasma (PRP) injections and extracorporeal shock wave therapy (ESWT). The purpose of this meta-analysis is to compare the effectiveness of PRP vs ESWT in the management of PF. METHODS A systematic search was performed of PubMed, Cochrane, and Google Scholar for randomized controlled trials comparing PRP to ESWT. Studies met inclusion criteria if mean and SDs for visual analog scale (VAS) pain scores and plantar fascia thickness (PFT) were reported. Mean differences were used to compare VAS pain score and PFT between PRP and ESWT. RESULTS Six randomized controlled trials, comparing a total of 214 subjects in the PRP group and 218 subjects in the ESWT group, were analyzed. A significantly greater statistical improvement was seen in the PRP group in VAS pain (mean difference = -0.67 [95% CI -1.16, -0.18], P = .007) and plantar fascia thickness (PFT) (mean difference = -0.56 [95% CI -0.77, -0.35], P < .001). CONCLUSION PRP had a statistically higher pain reduction than ESWT, but the difference does not reach clinical significance in this meta-analysis.
Collapse
Affiliation(s)
- Mohammad Daher
- Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Oscar Covarrubias
- Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Agustin Herber
- School of Osteopathic medicine, Midwestern University, Chicago, IL, USA
| | - Irvin Oh
- Department of Foot and Ankle Surgery, Yale University, New Haven, CT, USA
| | - Arianna L Gianakos
- Department of Foot and Ankle Surgery, Yale University, New Haven, CT, USA
| |
Collapse
|
3
|
Riiser MO, Husebye EE, Hellesnes J, Molund M. Outcomes After Proximal Medial Gastrocnemius Recession and Stretching vs Stretching as Treatment of Chronic Plantar Fasciitis at 6-Year Follow-up. Foot Ankle Int 2024; 45:1-9. [PMID: 37902240 PMCID: PMC10822063 DOI: 10.1177/10711007231205559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND Evidence from prospective short-term studies suggest that proximal medial gastrocnemius recession is a safe and efficient procedure to treat chronic plantar fasciitis resistant to nonoperative treatment. The aim of this study was to evaluate the long-term clinical outcomes of proximal medial gastrocnemius recession and stretching compared to a stretching exercise protocol for patients with chronic plantar fasciitis and an isolated gastrocnemius contracture (IGC). METHODS Forty patients with plantar fasciitis lasting more than 1 year were prospectively randomized to a home stretching exercise program only, or to proximal medial gastrocnemius recession in addition to the stretching program. Clinical and functional data in this study were obtained at baseline and 6-year follow-up. The main outcome was the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. Secondary outcomes were the visual analog scale (VAS) for pain, the Manchester Oxford Foot Questionnaire (MOxFQ), ankle dorsiflexion, and Achilles complex performance. RESULTS Thirty-three of 40 patients completed the 6-year follow-up. Seven patients had crossed over from nonoperative treatment to operative treatment. At 6 years, the operative group demonstrated significantly better outcomes with AOFAS (88.9 vs 78.6, P = .012), for pain measured by VAS (2.5 vs 5.5, P < .001) and with the MOxFQ total score (24.4 vs 45.9, P = .05) (per protocol analysis excluding crossovers). No between-group differences were observed for ankle dorsiflexion or Achilles complex performance at 6 years. CONCLUSION This study demonstrates that the improved function and reduced level of pain by proximal medial gastrocnemius recession and stretching is better compared to stretching alone after 6 years of follow-up for patients with chronic plantar fasciitis and a concomitant isolated gastrocnemius contracture. LEVEL OF EVIDENCE Level I, randomized controlled trial.
Collapse
Affiliation(s)
- Martin Okelsrud Riiser
- Department of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Østfold Hospital, Grålum, Norway
- Department of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Elisabeth Ellingsen Husebye
- Department of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Jan Hellesnes
- Department of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Marius Molund
- Department of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Østfold Hospital, Grålum, Norway
- University of Oslo, Faculty of Medicine, Oslo, Norway
| |
Collapse
|
4
|
Sankey T, Shah A. Response to "Letter Regarding: PROMIS Scores for Plantar Fasciitis Before and After Gastrocnemius Recession". Foot Ankle Int 2023; 44:937-938. [PMID: 37702361 DOI: 10.1177/10711007231191511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
|
5
|
Poenaru D, Sandulescu MI, Cinteza D. Pain Modulation in Chronic Musculoskeletal Disorders: Botulinum Toxin, a Descriptive Analysis. Biomedicines 2023; 11:1888. [PMID: 37509527 PMCID: PMC10376837 DOI: 10.3390/biomedicines11071888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/25/2023] [Accepted: 07/01/2023] [Indexed: 07/30/2023] Open
Abstract
Botulinum neurotoxin (BoNT), a product of Clostridium botulinum, reversibly inhibits the presynaptic release of the neurotransmitter acetylcholine at the neuromuscular junction. In addition, BoNT blocks the transmission of other substances involved in pain perception and, together with a soft-tissue anti-inflammatory effect, may play a role in analgesia. When first-line treatment fails, second-line therapies might include BoNT. Studies on chronic and recurrent pain using different mechanisms offer heterogenous results that must be validated and standardized. Plantar fasciitis, severe knee osteoarthritis, painful knee and hip arthroplasty, antalgic muscular contractures, and neuropathic and myofascial pain syndromes may benefit from the administration of BoNT. Research on this topic has revealed the main musculoskeletal conditions that can benefit from BoNT, stressing the effects, modalities of administration, doses, and schedule.
Collapse
Affiliation(s)
- Daniela Poenaru
- Rehabilitation Department 1, Carol Davila University of Medicine and Pharmacy, 4192910 Bucharest, Romania
| | - Miruna Ioana Sandulescu
- Doctoral School, Carol Davila University of Medicine and Pharmacy, 4192910 Bucharest, Romania
| | - Delia Cinteza
- Rehabilitation Department 1, Carol Davila University of Medicine and Pharmacy, 4192910 Bucharest, Romania
| |
Collapse
|
6
|
Ahn J, Yeo J, Lee SH, Lee YJ, Park Y, Goo B, Ha IH. Healthcare usage and cost for plantar fasciitis: a retrospective observational analysis of the 2010-2018 health insurance review and assessment service national patient sample data. BMC Health Serv Res 2023; 23:546. [PMID: 37231457 DOI: 10.1186/s12913-023-09443-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/25/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Plantar fasciitis (PF) is the most common cause of heel pain in adults, and the number of patients and medical expenses are increasing annually. However, studies on this condition are lacking. There is a need to investigate universally administered PF treatment and the associated costs. Therefore we analyzed the South Korean Health Insurance Review and Assessment Service data to investigate the distribution and healthcare usage of patients with PF. METHODS A cross-sectional retrospective observational design was used in this study. Patients diagnosed with PF (ICD-10 code M72.2) between January 2010 and December 2018 in South Korea, of whom 60,079 had used healthcare at least once, were included in the study. We assessed healthcare usage and cost due to PF, treatment method, and visit route. All statistical analyses were performed with descriptive statistics using SAS 9.4 version. RESULTS The number of treated cases of PF and patients with PF was 11,627 cases and 3,571 patients in 2010, respectively, which increased annually to 38,515 cases and 10,125 patients by 2018, respectively. The 45-54-year-old age group had the highest number of patients; the patient population was predominantly women. Physical therapy was used frequently in Western medicine (WM) institutions, where > 50% of the medicines prescribed to outpatients were analgesics. In contrast, acupuncture therapy was most commonly used in Korean medicine (KM) institutions. A high percentage of patients who visited a KM institution, followed by a WM institution, and then returned to the same KM institution had visited the WM institution for radiological diagnostic examination. CONCLUSION This study analyzed nine years of period data from a patient sample of claims data from the Health Insurance Review and Assessment Service to examine the current status of health service use for PF in Korea. We obtained information on the status of WM/KM institution visits for PF treatment, which could be useful for health policymakers. Study findings regarding treatments often used in WM/KM, the frequency of treatments, and their costs could be used as basic data by clinicians and researchers.
Collapse
Affiliation(s)
- Jaeseo Ahn
- Jaseng Hospital of Korean Medicine, 536 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea
| | - Jiyoon Yeo
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea
| | - Sook-Hyun Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea
| | - Yeoncheol Park
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Bonhyuk Goo
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea.
| |
Collapse
|
7
|
Thammajaree C, Theapthong M, Palee P, Pakpakorn P, Sitti T, Sakulsriprasert P, Bunprajun T, Thong-On S. Effects of radial extracorporeal shockwave therapy versus high intensity laser therapy in individuals with plantar fasciitis: A randomised clinical trial. Lasers Med Sci 2023; 38:127. [PMID: 37219650 DOI: 10.1007/s10103-023-03791-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/18/2023] [Indexed: 05/24/2023]
Abstract
This study aimed to compare the effects of radial extracorporeal shockwave therapy (rESWT) to the effects of high-intensity laser therapy (HILT) in the treatment of individuals with plantar fasciitis. Thirty-two individuals with unilateral plantar fasciitis were randomized into two groups: rESWT and HILT. In each group, the individuals underwent the intervention two sessions per week, for three weeks. Outcome measures included morning pain, resting pain, pain at 80 newtons (N) pressure, skin blood flow and temperature, plantar fascia (PF) and flexor digitorum brevis (FDB) thickness, and Foot Function Index (FFI). There was no significant difference in baseline characteristics of the individuals in both groups. All outcome measures, except skin blood flow and temperature, and FDB thickness, were significantly different (p < 0.05) over time. Skin blood flow was significantly different between groups at the end of the program. Either HILT or rESWT could alleviate pain in individuals with plantar fasciitis significantly. However, HILT was better at reducing FFI (functional limitation domain) rather than rESWT. This study was a randomized clinical trial and was approved by Mahidol University-Central Institutional Review Board (MU-CIRB) following the Declaration of Helsinki, COA no. MU_CIRB 2020/207.0412, the Thai Clinical Trials Registry (TDTR) numbered TCTR2021012500.
Collapse
Affiliation(s)
- Chutiporn Thammajaree
- Physical Therapy Center, Faculty of Physical Therapy, Mahidol University, Bangkok, 10700, Thailand
| | - Montartip Theapthong
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Phongsathon Palee
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Phrattaya Pakpakorn
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Tippawan Sitti
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Prasert Sakulsriprasert
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Tipwadee Bunprajun
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Suthasinee Thong-On
- Musculoskeletal Physical Therapy Research, Division of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| |
Collapse
|
8
|
Johannsen F, Konradsen L, Hansen P, Brinch S, Nybing JU, Krogsgaard MR. The Effect of Endoscopic Partial Plantar Fasciotomy on Morphologic and Functional Properties of the Foot. Foot Ankle Int 2023; 44:415-423. [PMID: 37002598 DOI: 10.1177/10711007231160741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND The lifetime risk of plantar fasciitis is 10%, and operative treatment in the form of endoscopic partial plantar fascia release are often performed in cases refractory for nonsurgical treatment. The effect of the operation on the biomechanical properties of the foot has only been sparsely studied. METHODS This is a prospective, observational study of 25 patients with plantar fasciitis, for a minimum of 3 months, verified by ultrasonographic scanning, who had endoscopic partial fasciotomy. A bony spur was resected if present. At the calcaneal insertion, the medial half of the central band of the plantar fascia was excised in full thickness. The biomechanical properties of the foot were evaluated before surgery and 12 months postoperatively. RESULTS Foot length increased 0.17 cm (P = .03), the width of the central zone 0.35 cm (P = .019), the modified arch index 0.05 (P = .032), and the Foot Posture Index 1.0 (P = .0014). There were no significant changes in rearfoot eversion angle, ankle dorsiflexion and jump distance, or in magnetic resonance imaging-measured 3D navicular position from pre- to postoperation, with or without loading, and no changes in ultrasonographically measured heel pad thickness. A tantalum bead (0.7-mm-diameter) was inserted during operation into the most proximal part of the released medial plantar fascia. Radiographs obtained few days postoperatively and 1 year later revealed no changes in the tantalum-calcaneus distance in supine position, but an increase from 48.3 to 50.7 mm (P = .045) in one-leg standing, suggesting a higher flexibility of the remaining fascia. Patients with a body mass index above and below 27.0 demonstrated no significant differences in any of the assessments at 12 months. CONCLUSION There were minimal changes in the measured foot morphologic and functional properties at 1-year follow-up, after endoscopic partial plantar fascia release. LEVEL OF EVIDENCE Level II, prospective cohort study.
Collapse
Affiliation(s)
- Finn Johannsen
- Department of Orthopedic Surgery, Institute of Sports Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Furesø-Reumatologerne, Private Rheumatology Clinic, Farum, Denmark
| | - Lars Konradsen
- Section for sports Traumatology, Department of Orthopedic Surgery, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Philip Hansen
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Signe Brinch
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Janus Uhd Nybing
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Michael Rindom Krogsgaard
- Section for sports Traumatology, Department of Orthopedic Surgery, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| |
Collapse
|
9
|
Zhu X, Liu J, Liu H, Liu J, Yang Y, Wang H. Effects of Midsole Hardness on the Mechanical Response Characteristics of the Plantar Fascia during Running. Bioengineering (Basel) 2023; 10:bioengineering10050533. [PMID: 37237604 DOI: 10.3390/bioengineering10050533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
High long-term stress on the plantar fascia (PF) is the main cause of plantar fasciitis. Changes in the midsole hardness (MH) of running shoes are an important factor leading to the alteration of the PF. This study aims to establish a finite-element (FE) model of the foot-shoe, and investigates the effects of midsole hardness on PF stress and strain. The FE foot-shoe model was built in ANSYS using computed-tomography imaging data. Static structural analysis was used to simulate the moment of running push and stretch. Plantar stress and strain under different MH levels were quantitatively analyzed. A complete and valid 3D FE model was established. With an increase in MH from 10 to 50 Shore A, the overall stress and strain of the PF were decreased by approximately 1.62%, and the metatarsophalangeal (MTP) joint flexion angle was decreased by approximately 26.2%. The height of the arch descent decreased by approximately 24.7%, but the peak pressure of the outsole increased by approximately 26.6%. The established model in this study was effective. For running shoes, increasing the MH reduces the stress and strain of PF, but also imposes a higher load on the foot.
Collapse
Affiliation(s)
- Xiaolan Zhu
- Sport Science School, Beijing Sport University, Beijing 100084, China
| | - Jiaojiao Liu
- Sport Science School, Beijing Sport University, Beijing 100084, China
| | - Hui Liu
- Sport Science School, Beijing Sport University, Beijing 100084, China
| | - Jingxi Liu
- School of Naval Architecture and Ocean Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Yufeng Yang
- Sport Science School, Beijing Sport University, Beijing 100084, China
| | - Haichun Wang
- Sport Science School, Beijing Sport University, Beijing 100084, China
| |
Collapse
|
10
|
Surgical treatment options for plantar fasciitis and their effectiveness: a systematic review and network meta-analysis. Arch Orthop Trauma Surg 2023:10.1007/s00402-022-04739-0. [PMID: 36596990 DOI: 10.1007/s00402-022-04739-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/15/2022] [Indexed: 01/05/2023]
Abstract
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.
Collapse
|
11
|
Castro-Méndez A, Palomo-Toucedo IC, Pabón-Carrasco M, Ortiz-Romero M, Fernández-Seguín LM. The Short-Term Effect of Dynamic Tape versus the Low-Dye Taping Technique in Plantar Fasciitis: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16536. [PMID: 36554416 PMCID: PMC9779572 DOI: 10.3390/ijerph192416536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Plantar fasciitis is a painful disorder that affects the plantar fascia of the foot, with a multifactorial aetiology. Dorsal flexion deficiency in the ankle is a risk factor for it. The provisional use of taping is described as part of conservative treatment. Dynamic Tape® is a type of tape that, adhered to muscles, allows for potential elastic energy to accumulate and dissipate later, optimizing its function. Therefore, it can offer immediate benefits while the patient awaits definitive treatment depending on the cause. OBJECTIVE To verify the effectiveness of Dynamic Tape® and the low-dye taping technique on pain intensity, ankle range of motion, and foot posture index. METHOD A randomised, double-blind clinical trial was conducted. A total of 57 subjects from the Clinical Podiatry Area of the University of Seville (Spain), clinically diagnosed with plantar fasciitis, were randomized into two groups. For one week, in the gastrocnemius-Achilles-plantar system, one group was treated with Dynamic Tape® and another group with low-dye taping. Pain, degrees of movement of dorsal flexion, and the foot posture index were measured in both groups before the intervention and one week after the intervention. A repeated-measures analysis of variance (ANOVA) was used to explore the differences between groups. RESULTS Significant differences in the decrease in pain intensity using Dynamic Tape® were found when comparing the treatments (p = 0.015) and the foot posture index was more normal in low-dye taping (p < 0.001). In both cases, the treatment showed similar behaviour with respect to the dorsal flexion ankle movement. CONCLUSION The effectiveness of Dynamic Tape®, compared to that of the low-dye taping, has a major benefit with regard to pain intensity from fasciitis, although it does not produce changes in the ankle range of motion and foot posture index. Consequently, Dynamic Tape® can be considered a taping technique with beneficial effects on pain intensity in the provisional approach to plantar fasciitis.
Collapse
Affiliation(s)
| | | | | | | | - Lourdes Mª Fernández-Seguín
- Physiotherapy Department, University of Seville, 41009 Seville, Spain
- Institute of Biomedicine of Seville, 41013 Seville, Spain
| |
Collapse
|
12
|
Wheeler PC, Dudson C, Calver R. Radial Extracorporeal Shockwave Therapy (rESWT) is not superior to "minimal-dose" rESWT for patients with chronic plantar fasciopathy; a double-blinded randomised controlled trial. Foot Ankle Surg 2022; 28:1356-1365. [PMID: 35817643 DOI: 10.1016/j.fas.2022.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/31/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Investigating outcomes following radial-extra-corporeal-shockwave-therapy (rESWT) in patients with chronic plantar fasciopathy METHODS: This double-blinded RCT in a single NHS Sports medicine clinic recruited 117 patients with chronic plantar fasciopathy randomised equally to either 3 sessions of rESWT or "minimal-dose" respectively. Mean age 51.7 ± 9.6 years, 66 % female, symptom duration: 32.6 ± 30.8 months. RESULTS "Average pain" improved by 50 % at 6-months, (>1/3 at interim time-points). Statistically significant within-group improvements were identified in pain, local function, and "ability" PROMs in both groups. Fewer benefits in activity levels or mood. No between-group differences were seen at the interim or final time-points. CONCLUSION 3 sessions of "recommended-dose" rESWT is non-superior to "minimal-dose" rESWT in patients with chronic plantar fasciopathy. rESWT may be ineffective in the treatment of patients with chronic plantar fasciopathy, "minimal-dose" rESWT may be sufficient for a therapeutic effect, or a greater number of treatment sessions may be required for benefit. LEVEL OF EVIDENCE Level I - Randomised controlled trial.
Collapse
Affiliation(s)
- Patrick C Wheeler
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, UK; School of Sport, Exercise and Health Sciences, Loughborough University, UK; National Centre of Sport and Exercise Medicine, Loughborough, UK.
| | - Chloe Dudson
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, UK
| | - Rachel Calver
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, UK
| |
Collapse
|
13
|
Cottom JM, Wolf JR, Sisovsky CA. Midterm Outcomes of Endoscopic Plantar Fascia Debridement in 125 Patients: A 5-Year Follow-Up. J Foot Ankle Surg 2022; 62:444-447. [PMID: 36443168 DOI: 10.1053/j.jfas.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/17/2022] [Accepted: 11/03/2022] [Indexed: 11/12/2022]
Abstract
Plantar fasciitis is one of the most common pathologies addressed by foot and ankle surgeons. Despite advances and overall success rates for conservative therapy, many of the recalcitrant cases proceed to require surgical correction. Partial to complete release of the fascia is often performed altering foot biomechanics and severing the windlass mechanism. Endoscopic debridement of the plantar fascia allows for direct visualization and removal of the inflammatory tissue while leaving the fascia and its function intact. A total of 125 feet were evaluated with a minimum follow-up time of 5 years. Gender, body mass index, and duration of symptoms were all evaluated and documented. Visual analog scale scores (VAS), American Orthopedic Foot and Ankle Score (AOFAS), and Foot Function Index (FFI) were collected both pre- and postoperatively. AOFAS, FFI, and VAS scores improved from a pre-operative mean of 57.6, 89.4%, and 8.6-89.1, 13.4%, and 0.7 respectively (p < .05) at final follow-up. Of the 125 patients, 98% stated they were satisfied with the operative outcome and would undergo the procedure again. At final follow-up, no patient suffered rupture of the fascia or recurrence. Patients were able to bear weight immediately following the surgery in a walking boot and on average patients were able to return to work at 3.4 days following surgery. This is a novel technique that does not compromise the plantar fascia or alter foot biomechanics with promising 5-year outcomes.
Collapse
Affiliation(s)
- James M Cottom
- Fellowship Director, Florida Orthopedic Foot and Ankle Center, Sarasota, FL.
| | - Joseph R Wolf
- Fellow, Florida Orthopedic Foot and Ankle Center, Sarasota, FL
| | - Charles A Sisovsky
- Fellowship Trained Foot and Ankle Surgeon, Orthopeadic Associates, Evansville, IN
| |
Collapse
|
14
|
Feeney KM. The Top 100 Cited Articles on Plantar Fasciitis: A Bibliometric Analysis. J Foot Ankle Surg 2022; 61:1246-1250. [PMID: 35331644 DOI: 10.1053/j.jfas.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 02/16/2022] [Indexed: 02/03/2023]
Abstract
Plantar fasciitis is a common musculoskeletal complaint seen in clinical practice. The objective of this study was to perform a bibliometric analysis of the top 100 articles published on the topic of plantar fasciitis. The Web of Science platform was used to search for articles on plantar fasciitis published between 1975 and 2021. Articles were subsequently ranked from the most to least cited. The top 100 studies were analyzed and their characteristics described. A total of 1859 articles were identified. The most cited article was "A retrospective case-control injuries analysis of 2002 running" published by Taunton JE et al in the British Journal of Sports Medicine in 2002. This article had a total of 910 citations. The mean number of citations per article in the top 100 was 139.95 (range 83-910). The majority of articles were published between the years 2000 to 2009 (n = 56). The USA had the highest number of publications (n = 55), while 'Foot and Ankle International' was the journal with the most publications in the top 100 (n =10). Plantar fasciitis is a well-studied topic. Despite this, however, a significant interest in plantar fasciitis research remains among clinicians and researchers evident by the high number of recent studies published on this topic. It is anticipated that these more recent studies will become highly cited over time and as such, this bibliometric analysis should be continuously updated.
Collapse
Affiliation(s)
- Kaylem M Feeney
- University of Limerick School of Medicine, Faculty of Education & Health Services, Castletroy, Co. Limerick, Ireland.
| |
Collapse
|
15
|
Alessio-Mazzola M, Stambazzi C, Ursino C, Tagliafico A, Trentini R, Formica M. Ultrasound-Guided Autologous Platelet-Rich Plasma Injections Versus Focal Ultrasound-Guided Extracorporeal Shockwave Therapy for Plantar Fasciitis in Athletes and Nonathletes: A Retrospective Comparative Study With Minimum 2-Year Follow-Up. J Foot Ankle Surg 2022; 62:417-421. [PMID: 36396549 DOI: 10.1053/j.jfas.2022.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 10/08/2022] [Accepted: 10/16/2022] [Indexed: 11/05/2022]
Abstract
Plantar fasciitis is often cause of heel pain, especially in sporting-related activities. Different conservative measures for the management of plantar fasciitis were compared in several researches. The purpose of this retrospective study was to evaluate and compare clinical outcomes of chronic plantar fasciitis treated with ultrasound-guided platelet-rich plasma (PRP) and focal ultrasound-guided extracorporeal shockwave therapy (ESW). Secondarily, results on subpopulation of athletes were recorded. Fifty-five patients treated for plantar fasciitis were included, 24 among them were competitive or recreational athletes. Treatment outcomes were assessed using Visual Analog Scale and Foot Function Index before and after treatment. Time to return to sport among patients practicing sporting activities was recorded. Before treatment, no differences were observed between groups in terms of age, gender, body mass index, and months of follow up. From baseline to final follow-up assessment, significant improvement was observed in all the outcomes measures. The subgroup analysis showed no differences between patients stratified for type of treatment and sport/nonsport practitioners. The overall failure rate was higher, although not significant, in patients who underwent ESW therapy and they required a higher number of orthopedic visits. Among sports practitioners the mean time to return to sport (months) was faster in PRP group than ESW group (p = .044). PRP and ESW represent both reliable solutions for plantar fasciitis leading to good results in terms of patients' satisfaction, pain, and clinical outcomes. However, after treatment with PRP injections less recurrences in overall population and faster return to sporting activities in sports practitioners were observed.
Collapse
Affiliation(s)
| | - Chiara Stambazzi
- Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genova, Genova, Italy; Ospedale Policlinico San Martino, Genova, Italy
| | - Chiara Ursino
- Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genova, Genova, Italy; Ospedale Policlinico San Martino, Genova, Italy
| | - Alberto Tagliafico
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy; Ospedale Policlinico San Martino, Genova, Italy
| | - Roberto Trentini
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Matteo Formica
- Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genova, Genova, Italy; Ospedale Policlinico San Martino, Genova, Italy
| |
Collapse
|
16
|
Seasonal Variation for Plantar Fasciitis: Evidence from Google Trends Search Query Data. Healthcare (Basel) 2022; 10:healthcare10091676. [PMID: 36141288 PMCID: PMC9498888 DOI: 10.3390/healthcare10091676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
We aimed to determine the seasonal trends in internet searches for plantar fasciitis and related symptoms in various countries using search engine query data on Google. We used Google Trends to obtain internet search query data from January 2009 to December 2019. We collected monthly search volumes for the query terms “plantar fasciitis” and “heel pain” in the USA, Canada, the U.K., Ireland, Australia, and New Zealand. Statistical analysis of the seasonal effects on plantar fasciitis was performed using a cosinor model. The cosinor analyses confirmed statistically significant seasonal patterns in the relative search volumes for the terms “plantar fasciitis” and “heel pain” in the USA, Canada, the U.K., Ireland, and Australia, with peaks during the summer and troughs during the winter. For New Zealand, the seasonal trend was statistically significant only for the term “plantar fasciitis”, while a similar trend for the term “heel pain” was present without achieving statistical significance for seasonality. This seasonality is thought to be related to more frequent occurrence of plantar fasciitis due to increased physical activity of people during the warmer months. In this study, the search query data using the terms “plantar fasciitis” and “heel pain” on Google Trends show significant seasonal variation across several countries, with a peak in the summer and a trough in the winter.
Collapse
|
17
|
Johannsen F, Magnusson SP. The relationship between ultrasonography with or without contrast and the clinical outcome in plantar fasciitis. Scand J Med Sci Sports 2022; 32:1660-1667. [PMID: 35908203 DOI: 10.1111/sms.14221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Plantar fasciitis (PF) is a common disorder without objective parameters for disease severity. PURPOSE to investigate whether structural changes in the plantar fascia and heel fat pad determined by ultrasound scanning with or without contrast is related to outcome measures in patients with symptomatic PF, and to investigate whether there is an association between changes in US findings and improvement in pain and function. METHODS All patients (n=90) in a randomized controlled trial treated with training and/or glucocorticosteroid injection were assessed for morning pain, function pain, Foot Function Index (FFI) and ultrasound measured thickness of the fascia and heel fat pad at entry, and after 6 months. Thirty patients were included in a longitudinal study that assessed pain, function and microvascular volume (MV) by Contrast Enhanced Ultrasound at entry and after 5 months of treatment. RESULTS None of the ultrasound parameters at the initial examination were related to clinical outcomes at 5-6 months. Changes in US measured thickness of the fascia but not the fat pad correlated with improvement in all outcome measures at 6 months (FFI: r=0.30, p=0.005, morning pain: r=0.21, p=0.046, function pain: r=0.28, p=0.007. MV did not change despite significant improvement in symptoms. CONCLUSION Changes in ultrasound measured fascia thickness is associated with clinical improvement in PF patients.
Collapse
Affiliation(s)
- F Johannsen
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Furesø-reumatologerne, Farum, Denmark
| | - S P Magnusson
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| |
Collapse
|
18
|
MacRae CS, Roche AJ, Sinnett TJ, O’Connell NE. What is the evidence for efficacy, effectiveness and safety of surgical interventions for plantar fasciopathy? A systematic review. PLoS One 2022; 17:e0268512. [PMID: 35584180 PMCID: PMC9116678 DOI: 10.1371/journal.pone.0268512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 05/01/2022] [Indexed: 11/28/2022] Open
Abstract
Aims To systematically review randomised control trials (RCT’s) assessing the effectiveness and safety of surgical interventions in adults with plantar fasciopathy (PF). Materials and methods We searched MEDLINE, EMBASE, Web of Science, Google Scholar, the Cochrane Central Register of Controlled Trials, trial registries and references lists. RCT’s comparing surgical interventions with non-surgical or surgical comparisons in adults with PF were included. Primary outcomes were changes in first step pain severity/intensity, and incidence/nature of adverse events. Secondary outcomes included foot and ankle related disability/function, health related quality of life, cost effectiveness, changes in other reported measures of pain and medication use. Data were extracted at short-term (≤3 months post-intervention), medium-term (>3months—≤6 months post-intervention) or long-term (>6 months—≤2 years post-treatment). Certainty of evidence was evaluated using the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results From 3620 screened records, we included 8 studies comprising 345 patients. Substantial variation across trials precluded meta-analysis, hence a narrative synthesis was conducted. We judged all studies to have high risk of bias. For all outcome comparisons our GRADE judgement for the certainty of the evidence was very low. Three studies compared one type of surgery with another largely showing little to no difference in outcomes for pain, function or quality of life. Five studies compared surgery with non-surgical interventions—three providing very low certainty evidence that surgery may improve pain and function at long-term follow-up compared to non-surgical comparisons, whereas two studies provided no long-term between-group differences. Reporting of adverse events were inadequate, inconsistent or absent across all studies. Conclusion There is a paucity of high certainty evidence to support or refute the effectiveness and safety of surgical interventions in the management of PF. We make recommendations for improving the evidence base in this field.
Collapse
Affiliation(s)
- C. Sian MacRae
- Department of Health Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, United Kingdom
- Department of Physiotherapy, Therapy Services, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Andrew J. Roche
- Department of Orthopaedics, Foot and Ankle Unit, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Tim J. Sinnett
- Department of Orthopaedics, Foot and Ankle Unit, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Neil E. O’Connell
- Department of Health Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, United Kingdom
- * E-mail:
| |
Collapse
|
19
|
Caicedo Gutiérrez L, Moreno Martínez D. Case report: Baxter's nerve radiofrequency in patient with plantar fasciitis nonresponsive to conventional treatment. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2022; 69:306-309. [PMID: 35577703 DOI: 10.1016/j.redare.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 02/04/2021] [Indexed: 06/15/2023]
Abstract
Plantar fasciitis is recognized as the leading cause of talalgia worldwide. In the vast majority of cases it can be controlled with the use of appropriate footwear, stretching exercises and changes in the sport activity, while a few cases require infiltrations or surgical interventions. The latter puts the patient at greater risk, and is reserved for the most severe cases. We propose using pulsed radiofrequency ablation of Baxter's nerve to treat this painful symptom in patients who do not respond adequately to conventional treatment. We present the case of a patient with refractory plantar fasciitis in whom surgery had been ruled out. The patient underwent pulsed radiofrequency treatment with satisfactory results in the short and medium term.
Collapse
Affiliation(s)
| | - D Moreno Martínez
- Dolor y Cuidado Paliativo, Hospital Universitario San Ignacio, Bogotá DC, Colombia; Departamento de Anestesiología, Pontificia Universidad Javeriana, Bogotá DC, Colombia
| |
Collapse
|
20
|
Wheeler PC, Dudson C, Gregory KM, Singh H, Boyd KT. Autologous Blood Injection With Dry-Needling vs Dry-Needling Alone Treatment for Chronic Plantar Fasciitis: A Randomized Controlled Trial. Foot Ankle Int 2022; 43:646-657. [PMID: 35068224 DOI: 10.1177/10711007211061365] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Autologous blood injection (ABI) for patients with chronic plantar fasciitis has been promoted as an approach to improve outcomes over standard dry-needling approaches. The purpose of this trial was to investigate if there are improved outcomes following an ultrasonography-guided ABI compared to dry needling alone for patients with chronic plantar fasciitis. METHODS A double-blinded (participant-blinded and observer-blinded) RCT within a single clinic enrolled 90 patients with symptoms of plantar fasciitis that had failed to improve with a minimum of 3 months of rehabilitation. The mean age was 49.5±8.9 years, 67% were female, and the mean symptom duration was 40.0±28.2 months (range: 8 months-10 years). Participants were randomized to receive ABI or an identical dry-needle fenestration-procedure without coadministration of autologous blood. All participants received identical structured rehabilitation and were followed up at 2, 6, 12, and 26 weeks. Outcome measures included local foot pain, validated foot patient-reported outcome measures (Foot Function Index-revised, Manchester-Oxford Foot Questionnaire, Foot and Ankle Ability Measure), measures of general function and "ability" (EuroQol [EQ]-5D-5L, Oswestry Disability Index), specific measures of activity (International Physical Activity Questionnaire), sleep (Pittsburgh Sleep Quality Index), and mood (Hospital Anxiety and Depression Scale). RESULTS There were no significant between-group differences seen at any time-point studied. There were a number of statistically significant within-group improvements for local foot pain and function in both groups comparing baseline/follow-up data. Overall, levels of pain improved by 25% by 6 weeks and by 50% at 6 months. There were improvements in some generalized function markers. Activity rates did not change, demonstrating that improvements in pain did not necessarily influence physical activity. CONCLUSION Coadministration of 3 mL of autologous blood had no additional effect compared to a dry-needling procedure alone for patients with chronic plantar fasciitis. LEVEL OF EVIDENCE Level I, double-blinded randomized controlled trial.
Collapse
Affiliation(s)
- Patrick C Wheeler
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, United Kingdom.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom.,National Centre of Sport and Exercise Medicine, Loughborough, United Kingdom
| | - Chloe Dudson
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, United Kingdom
| | - Kim M Gregory
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, United Kingdom.,National Centre of Sport and Exercise Medicine, Loughborough, United Kingdom
| | - Harjinder Singh
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, United Kingdom.,National Centre of Sport and Exercise Medicine, Loughborough, United Kingdom
| | - Kevin T Boyd
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, United Kingdom
| |
Collapse
|
21
|
Abstract
BACKGROUND This systematic review aims to summarize the outcomes of gastrocnemius recession in the treatment of plantar fasciitis. METHODS A systematic review was performed according to PRISMA guidelines using the PubMed, Embase, Emcare, Web of Science, Scopus, and CINAHL databases. A 2-stage title/abstract and full text screening process was performed independently by 2 reviewers. Randomized controlled trials, cohort, and case-control studies reporting the results of gastrocnemius recession in patients with plantar fasciitis were included. The MINORS and Joanna Briggs Institute Criteria were used to assess study quality and risk of bias. RESULTS A total of 285 articles were identified, with 6 of these studies comprising 118 patients being ultimately included. Significant postoperative improvement in American Orthopaedic Foot & Ankle Society, visual analog scale, 36-Item Short Form Health Survey, Foot Forum Index, and Foot and Ankle Ability Measure scores were reported. Included studies also described an increase in ankle dorsiflexion range of motion and plantarflexion power. An overall pooled complication rate of 8.5% was seen, with persistent postoperative pain accounting for the most common reported complication. Gastrocnemius recession is associated with greater postoperative improvement than plantar fasciotomy and conservative stretching exercises. CONCLUSION The current evidence demonstrates that gastrocnemius recession is effective in the management of plantar fasciitis, specifically in patients with gastrocnemius contracture who do not respond to conservative treatment. LEVEL OF EVIDENCE Level III, Systematic review of level I-III studies.
Collapse
Affiliation(s)
- Zaki Arshad
- School of Clinical Medicine, University
of Cambridge, Cambridge, UK
- Zaki Arshad, BA, School of Clinical
Medicine, University of Cambridge, Downing College, Box 111 Cambridge Biomedical
Campus, Regent Street, Cambridge, CB2 1DQ, UK.
| | - Aiman Aslam
- School of Clinical Medicine, University
of Cambridge, Cambridge, UK
| | | | - Maneesh Bhatia
- Department of Trauma and Orthopaedic
Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK
| |
Collapse
|
22
|
Colberg RE, Kenneth-Nwosa KO, Jurado Vélez JA, Slowik JS, Fleisig GS. Clinical and Imaging Outcomes of Plantar Fasciotomy Using Microdebrider Coblation Wand. FOOT & ANKLE ORTHOPAEDICS 2022; 7:24730114221091797. [PMID: 35479331 PMCID: PMC9036336 DOI: 10.1177/24730114221091797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: 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. Methods: 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. Results: 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 (P < .001), FADI 107±16 (P < .001), FAAMA 95%±10% (P < .001), FAAMS 84%±19% (P < .001), and plantar fascia thickness 6.8 ± 1.2 mm (P = .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. Conclusion: 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 of Evidence: Level IV, prospective case series.
Collapse
Affiliation(s)
- Ricardo E. Colberg
- Andrew's Sports Medicine and Orthopedic Center, Pelham, AL, USA
- American Sports Medicine Institute, Birmingham, AL, USA
| | - Ken O. Kenneth-Nwosa
- Andrew's Sports Medicine and Orthopedic Center, Pelham, AL, USA
- American Sports Medicine Institute, Birmingham, AL, USA
| | | | | | | |
Collapse
|
23
|
Similar Benefits Seen After Radial Extracorporeal Shockwave Therapy or Autologous Blood Injection in Patients With Chronic Plantar Fasciitis-A Retrospective Cohort Study. Clin J Sport Med 2022; 32:e107-e115. [PMID: 34267064 DOI: 10.1097/jsm.0000000000000930] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 02/13/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare the outcomes for patients with chronic plantar fasciitis after extracorporeal shockwave therapy (ESWT) or autologous blood injection (ABI). DESIGN Cohort study-retrospective analysis of prospectively collected data. SETTING Hospital-based Sports Medicine Outpatient Clinic. PATIENTS One hundred two consecutive patients with chronic plantar fasciitis, treated with either radial-ESWT (rESWT) (n = 54) or ABI (n = 48), with minimum 3-month follow-up and 96% (98/102) having 6-month follow-up. Mean age 49.5 years and mean duration of symptoms 37.5 months before treatment. INTERVENTIONS Patients received either 3 sessions of radial ESWT (one session per week for 3 weeks), or a single ultrasound-guided dry needling and ABI (3 mL whole autologous blood). All patients received standardized after-care, including progressive structured home exercise program of flexibility, strengthening, and proprioception exercises. MAIN OUTCOME MEASURES 0 to 10 numerical rating scale (NRS) for self-reported "average pain" and "average stiffness" values. Secondary outcome measures included assessments of local foot function [including Manchester-Oxford Foot Questionnaire (MOXFQ), revised-Foot Function Index] as well as markers of mental health functioning (HAD), global health (EQ-5D-5L), and physical activity (International Physical Activity Questionnaire). RESULTS This study demonstrated statistically significant improvements in self-reported measures of pain and local foot function after either procedure at 6 weeks, 3 months, and 6 months, but no statistically significant differences were seen between groups at any time-period studied. At 6 months, the average pain using a 0 to 10 NRS was improved from 6.8 ± 1.8 to 4.0 ± 2.7 (P < 0.001) after ESWT and from 7.1 ± 1.6 to 3.8 ± 2.7 (P < 0.001) after ABI. At 6 months, significant improvements were seen following either group using a number of different validated patient-rated outcome measures assessing local foot pain and function, eg, the total score for MOXFQ improved from 56.1 ± 12.8 to 42.5 ± 16.6 (P < 0.001) after ESWT and from 58.8 ± 13.2 to 44.2 ± 19.2 (P < 0.001) after ABI. However, measures of physical activity or wider aspects of patient functioning did not consistently improve from baseline values to follow-up periods. CONCLUSIONS Patients with chronic plantar fasciitis improved to statistically significant extent after either rESWT or ABI procedures, with no significant differences seen between groups. The lack of randomization in this pragmatic study is noted, which may have influenced the outcome seen. Potentially larger and more robust studies are required to investigate this treatment comparison further.
Collapse
|
24
|
Thor J, Mao DW, Chandrakumara D, Zheng Q, Yoo TW, Kon Kam King C. Radiofrequency microtenotomy for plantar fasciitis: A systematic review and meta-analysis. Foot (Edinb) 2022; 50:101869. [PMID: 35219133 DOI: 10.1016/j.foot.2021.101869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/09/2021] [Accepted: 09/22/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Currently, there is limited evidence on outcomes for plantar fascia radiofrequency microtenotomy. An evidence-based systematic review and meta-analysis for outcomes of radiofrequency microtenotomy for the treatment of plantar fasciitis was conducted. METHODS A comprehensive evidence-based literature review of PubMed and Cochrane Databases was conducted in March 2019, which identified 11 relevant articles assessing the efficacy of plantar fascia radiofrequency microtenotomy. The studies were then assigned to a level of evidence (I-IV). Individual studies were reviewed to provide a grade of recommendation (A-C, I) according to the Wright classification in support of or against endoscopic plantar fascia release. Meta-analysis was performed for 7 of the studies that measured AOFAS scores. RESULTS Based on the results of this evidence-based review, there was fair (grade B) evidence to support plantar fascia radiofrequency microtenotomy. There was a statistically significant mean increase of 40.9 in AOFAS scores post procedure. CONCLUSION There was fair (grade B) evidence to recommend radiofrequency microtenotomy for plantar fasciitis. There is a need for more high quality level I randomized controlled trials with validated outcome measures to allow for stronger recommendations to be made. LEVEL OF EVIDENCE Level II, systematic review of level II studies.
Collapse
Affiliation(s)
- Jessica Thor
- Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, 529889, Singapore.
| | - David Weijia Mao
- Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, 529889, Singapore
| | - Darshana Chandrakumara
- Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, 529889, Singapore
| | - Qishi Zheng
- Department of Epidemiology, Singapore Clinical Research Institute, 31 Biopolis Way, 138669, Singapore
| | - Tae Wook Yoo
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Charles Kon Kam King
- Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, 529889, Singapore
| |
Collapse
|
25
|
Leggit J, Mark R, Hulsopple C, Carey PM, Alisangco JB. Disorders of the Lower Extremity. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
26
|
Balius R, Bossy M, Pedret C, Porcar C, Valle X, Corominas H. Heel fat pad syndrome beyond acute plantar fascitis. Foot (Edinb) 2021; 48:101829. [PMID: 34399148 DOI: 10.1016/j.foot.2021.101829] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 05/06/2021] [Accepted: 05/22/2021] [Indexed: 02/04/2023]
Abstract
Heel pain is a frequent cause of pain and disability in adult active population. In patients with this clinical presentation, several causes must be ruled out, among them plantar fasciitis the most common. Other etiologies of plantar heel pain are the entrapment of muscular branch of the lateral plantar nerve (Baxter nerve) or fat pad atrophy, being the last one the second cause of heel pain after plantar fasciitis. A case series of patients with pathological findings of the heel fat pad area using MRI and US to provide a differential diagnosis of heel pain. Observational case series study. Nine patients visited presented with pain in the plantar aspect of the heel. The plantar aspect of the heel was evaluated in detail with US and MRI. Main inclusion criteria were to present acute or chronic pain on the plantar aspect. In five cases the right heel was affected, in three cases the left heel. One case presented bilateral complaints. All patients presented mechanical pain. Specifically, four of them also described a constant clunk during footstep. Heel fat pad lesion was confirmed with MRI and US in the medial aspect, observed in five patients. In four patients, the heel fat pad was globally affected respectively. This case series tries to put some light on other heel conflicts beside plantar fasciitis that should be ruled out, being one of those, heel fat pad atrophy. Our presentation highlight the role that bed side ultrasound can play in the definition of a specific pattern confirmed with MRI after the US.
Collapse
Affiliation(s)
- Ramon Balius
- Consell Català de L'Esport, Generalitat de Catalunya, Barcelona, Catalonia, Spain; Clínica Diagonal, Barcelona, Catalonia, Spain
| | - Mireia Bossy
- Clínica Diagonal, Barcelona, Catalonia, Spain; Clínica Creu Blanca, Barcelona, Catalonia, Spain
| | - Carles Pedret
- Clínica Diagonal, Barcelona, Catalonia, Spain; Clínica Creu Blanca, Barcelona, Catalonia, Spain
| | - Carme Porcar
- Centre Alt Rendiment, Sant Cugat del Vallès, Catalonia, Spain
| | - Xavier Valle
- Futbol Club Barcelona, Serveis Mèdics, Barcelona, Catalonia, Spain
| | - Hèctor Corominas
- Clínica Diagonal, Barcelona, Catalonia, Spain; Servei de Reumatologia, Hospital Universitari de Sant Pau, Barcelona, Catalonia, Spain.
| |
Collapse
|
27
|
Caicedo Gutiérrez L, Moreno Martínez D. Case report: Baxteŕs nerve radiofrequency in patient with plantar fasciitis nonresponsive to conventional treatment. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2021; 69:S0034-9356(21)00100-6. [PMID: 34289957 DOI: 10.1016/j.redar.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 11/07/2020] [Accepted: 02/04/2021] [Indexed: 11/19/2022]
Abstract
Plantar fasciitis is recognized as the leading cause of talalgia worldwide. In the vast majority of cases it can be controlled with the use of appropriate footwear, stretching exercises and changes in the sport activity, while a few cases require infiltrations or surgical interventions. The latter puts the patient at greater risk, and is reserved for the most severe cases. We propose using pulsed radiofrequency ablation of Baxter's nerve to treat this painful symptom in patients who do not respond adequately to conventional treatment. We present the case of a patient with refractory plantar fasciitis in whom surgery had been ruled out. The patient underwent pulsed radiofrequency treatment with satisfactory results in the short and medium term.
Collapse
Affiliation(s)
| | - D Moreno Martínez
- Dolor y Cuidado Paliativo, Hospital Universitario San Ignacio, Bogotá DC, Colombia; Departamento de Anestesiología, Pontificia Universidad Javeriana, Bogotá DC, Colombia
| |
Collapse
|
28
|
Król P, Franek A, Król T, Stanula A, Dolibog P, Durmała J, Polak A, Kuszewski M, Stania M. Ground reaction force analysis for assessing the efficacy of focused and radial shockwaves in the treatment of symptomatic plantar heel spur. J Back Musculoskelet Rehabil 2021; 34:279-287. [PMID: 33285624 DOI: 10.3233/bmr-191739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Extracorporeal shock wave therapy is among the conservative treatments for symptomatic heel spur. OBJECTIVE The purpose of this trial is to evaluate and compare the therapeutic effects of radial shock wave (RSWT) and focused shock wave (FSWT) applied in the treatment of symptomatic heel spur. METHODS Fifty-five participants were randomly divided into two comparative groups that were administered FSWT and RSWT, respectively. The severity of dysfunction (Foot Function Index, FFI), ground reaction forces (GRF) and walking temporal parameters were measured in all patients at baseline and at weeks 1, 3, 6, 12 and 24 after treatment. RESULTS In both groups, a gradual decrease in the FFI values occurred after treatment. The percentage reduction in the FFI was comparable for both groups. Statistically significant changes were only noted between some measurements of GRF and walking temporal parameters. The percentage changes in the values of the force and temporal parameters were similar between the groups. CONCLUSIONS Both FSWT and RSWT are efficacious in the treatment of symptomatic heel spur and their therapeutic effects are comparable. Objective data registered by force platforms during walking are not useful for tracing the progress of treatment applied to patients with symptomatic heel spur between consecutive procedures.
Collapse
Affiliation(s)
- Piotr Król
- Academy of Physical Education, Institute of Sport Sciences, Katowice, Poland
| | - Andrzej Franek
- Chair and Department of Medical Biophysics, School of Medicine, Medical University of Silesia, Katowice, Poland
| | - Tomasz Król
- Department of Kinesitherapy and Special Methods, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Arkadiusz Stanula
- Academy of Physical Education, Institute of Sport Sciences, Katowice, Poland
| | - Paweł Dolibog
- Chair and Department of Medical Biophysics, School of Medicine, Medical University of Silesia, Katowice, Poland
| | - Jacek Durmała
- Department of Rehabilitation, School of Health Sciences, Medical University of Silesia, Katowice-Ochojec, Poland
| | - Anna Polak
- Academy of Physical Education, Institute of Sport Sciences, Katowice, Poland
| | - Michał Kuszewski
- Academy of Physical Education, Institute of Physiotherapy and Health Sciences, Katowice, Poland
| | - Magdalena Stania
- Academy of Physical Education, Institute of Sport Sciences, Katowice, Poland
| |
Collapse
|
29
|
Rushing CJ, Rathnayake VR, Oxios AJ, Spinner SM, Hardigan P. Patient-Perceived Recovery and Outcomes after Bipolar Radiofrequency Controlled Ablation with Platelet-Rich Plasma Injection for Refractory Plantar Fasciosis. J Foot Ankle Surg 2021; 59:673-678. [PMID: 32600560 DOI: 10.1053/j.jfas.2019.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 07/14/2019] [Accepted: 07/18/2019] [Indexed: 02/03/2023]
Abstract
Previous studies have documented persistent postoperative symptoms and limitations following plantar fasciotomy using patient-reported outcome measures (PROMs). The incomplete recovery (resolution) has been theorized to occur from altered foot biomechanics, and alternative treatment methods have continued to gained popularity for addressing refractory plantar fasciosis (RPF). The purpose of the present study was to assess patient-perceived recovery (PPR) and outcomes after bipolar radiofrequency controlled ablation (BRC) with platelet-rich plasma (PRP) injection for RPF. From July 2006 to July 2016, 43 patients (52 procedures) were enrolled. PROMS were prospectively obtained and compared between patients who perceived themselves as recovered without/residual deficits (recovered-resolved, recovered-not resolved) and those not recovered. Holistic satisfaction, procedure-specific satisfaction, complications, reoperations, and failure were recorded. Overall, 67.4% perceived themselves as recovered-resolved, 23.3% as recovered-not resolved, and 9.3% as not recovered. Holistic and procedure specific satisfaction were high (90.7% and 88.4%), with a mean modified Foot Function Index of 11.65, visual analog scale for pain 1.5, and failure rate of 9.3% at a median of 53 months (interquartile range 33 to 83). In the present study, outcomes with BRC with PRP injection compared favorably to the long-term outcomes reported for partial and complete plantar fasciotomy. Although 14 patients (32.6%) continued to have some postoperative symptoms, 71% indicated that they were satisfied with their symptoms, and 64% would undergo a similar procedure again. Therefore, despite the study's shortcomings, a patient's ability to cope appears to have a role in recovery from RPF.
Collapse
Affiliation(s)
- Calvin J Rushing
- Resident, Westside Regional Medical Center, Plantation, FL; Board Member, Foot and Ankle Research Foundation of South Florida Inc., Plantation, FL.
| | | | - Adam J Oxios
- Resident, Westside Regional Medical Center, Plantation, FL
| | - Steven M Spinner
- Board Member, Foot and Ankle Research Foundation of South Florida Inc., Plantation, FL; Residency Director, Westside Regional Medical Center, Plantation, FL
| | - Patrick Hardigan
- Director, Statistical Consulting Center, Nova Southeastern University, Ft. Lauderdale, FL
| |
Collapse
|
30
|
James IB, Gusenoff BR, Wang S, DiBernardo G, Minteer D, Gusenoff JA. A Step in the Right Direction: A Prospective Randomized, Controlled Crossover Trial of Autologous Fat Grafting for Rejuvenation of the Heel. Aesthet Surg J 2021; 41:NP959-NP972. [PMID: 33615336 DOI: 10.1093/asj/sjab095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The shock-absorbing soft tissues of the heel are composed of dermis and specialized fat pads. Heel fat pad atrophy is common and can be painful and debilitating. In our previous work, autologous fat grafting was effective for treating pain from forefoot fat pad atrophy. OBJECTIVES The authors hypothesized that autologous fat grafting to the heel would relieve pain and improve function in patients with heel fat pad atrophy. METHODS Patients with heel fat pad atrophy and associated pain were recruited and randomized into 2 groups. Group 1 received autologous fat grafting on enrollment and was followed for 2 years. Group 2 received offloading and activity modification for 1 year, then crossed over, underwent autologous fat grafting, and was followed for 1 year afterward. Outcome measures included ultrasound-measured fat pad and dermal thickness; pedobarograph-measured foot pressures and forces; and patient-reported outcomes as measured by the Manchester Foot Pain and Disability Index. RESULTS Thirteen patients met the inclusion criteria and completed the study. Seven (12 affected feet) were randomized into Group 1; and 6 (9 affected feet) were randomized into Group 2. The average age was 55 years and BMI was 30.5 kg/m2. Demographics did not significantly differ between groups. Heel fat pad thickness increased after autologous fat grafting but returned to baseline at 6 months. However, autologous fat grafting increased dermal thickness significantly and also increased fat pad thickness under a compressive load compared with controls at 6 and 12 months. Foot pain, function, and appearance were also significantly improved compared with controls at 6 and 12 months. CONCLUSIONS Autologous fat grafting improved patient-reported foot pain, function, and appearance and may rejuvenate local soft tissues in patients with heel fat pad atrophy. LEVEL OF EVIDENCE: 3
Collapse
Affiliation(s)
- Isaac B James
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Beth R Gusenoff
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sheri Wang
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Gabriella DiBernardo
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Danielle Minteer
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | |
Collapse
|
31
|
Newman DP, Holkup KC, Jacobs AN, Gallo AC. Recalcitrant Flexor Hallucis Longus Dysfunction: A Case Study Demonstrating the Successful Application of an Adaptable Rehabilitation Program With a Two-Year Follow-Up. Cureus 2021; 13:e14326. [PMID: 34079644 PMCID: PMC8159326 DOI: 10.7759/cureus.14326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Flexor hallucis longus (FHL) dysfunction is a condition experienced primarily by athletes, including ballet dancers and runners. Accurate diagnosis and definitive treatment at the initial evaluation can often be difficult given the number of foot and ankle pathologies that share similar signs and symptoms. The evaluation process tends to be a diagnosis of inclusion rather than a specific pathology with an accepted rehabilitation plan. For example, patients with medial arch pain may undergo an extended rehabilitation period with an evolving differential diagnosis requiring several treatment modifications. A more appropriate rehabilitation paradigm should adapt to the potential changes in patient symptoms and presentation, addressing functional impairments as they arise. This case study describes the successful management of a patient with chronic FHL dysfunction, leveraging a flexible, multimodal treatment approach to address the evolving functional impairments rather than focusing on a single, discrete diagnosis. At a two-year follow-up, the patient remains pain-free.
Collapse
Affiliation(s)
- David P Newman
- Pain Management-Physiotherapy, Tripler Army Medical Center, Honolulu, USA
| | | | - Aimee N Jacobs
- Physical Therapy, Tripler Army Medical Center, Honolulu, USA
| | | |
Collapse
|
32
|
Tang Y, Deng P, Wang G, Yao Y, Luo Z, Xu Y. The Clinical Efficacy of Two Endoscopic Surgical Approaches for Intractable Plantar Fasciitis. J Foot Ankle Surg 2021; 59:280-285. [PMID: 32130991 DOI: 10.1053/j.jfas.2019.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 03/10/2019] [Accepted: 08/18/2019] [Indexed: 02/03/2023]
Abstract
In this randomized retrospective study, 2 different endoscopic approaches were used to treat intractable plantar fasciitis with the aim to reduce complications and improve therapeutic effects. The lateral double incisions group included 23 feet in 22 patients, and the medial and lateral incisions group included 21 feet in 19 patients. Both groups were treated with endoscopy through the suprafascial approach. Patients were evaluated using the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale (AOFAS-AHS) and visual analog scale (VAS) preoperatively and 3, 6, 12, and 24 months postoperatively. At the final follow-up, the Roles-Maudsley (R-M) score was used to determine patient satisfaction. The AOFAS-AHS scores of the lateral double incisions group were 54.54 ± 7.02 preoperatively and 97.71 ± 3.67 postoperatively. Similarly, AOFAS-AHS scores in the medial and lateral incisions group were 55.52 ± 6.41 preoperatively and 96.64 ± 3.18 postoperatively. There was no significant difference in AOFAS-AHS scores between groups before and after surgery. The time to full weightbearing after surgery and the time to return to full athletic activities in the 2 groups showed no significant difference. The postoperative VAS scores were significantly lower than the preoperative values for both groups. However, no differences were noted in VAS scores or R-M scores postoperatively between the 2 groups. In the medial and lateral incisions group, 3 cases of injury of the first branch of the lateral plantar nerve occurred postoperatively. In conclusion, both endoscopic approaches are effective in the treatment of intractable plantar fasciitis. The lateral double incisions approach showed a lower incidence of nerve injury.
Collapse
Affiliation(s)
- Yong Tang
- Surgeon, Department of Orthopaedics, 72nd Group Army Hospital, Huzhou University, Huzhou, Zhejiang, China
| | - Pan Deng
- Surgeon, Department of Orthopaedics, 72nd Group Army Hospital, Huzhou University, Huzhou, Zhejiang, China
| | - Gang Wang
- Surgeon, Department of Orthopaedics, 72nd Group Army Hospital, Huzhou University, Huzhou, Zhejiang, China
| | - Yourong Yao
- Surgeon, Department of Orthopaedics, 72nd Group Army Hospital, Huzhou University, Huzhou, Zhejiang, China
| | - Zhengli Luo
- Surgeon, Department of Orthopaedics, 72nd Group Army Hospital, Huzhou University, Huzhou, Zhejiang, China
| | - Yunqin Xu
- Professor, Department of Orthopaedics, 72nd Group Army Hospital, Huzhou University, Huzhou, Zhejiang, China.
| |
Collapse
|
33
|
Abstract
Introduction: Platelet-rich plasma (PRP) is an autologous blood-derived product that contains platelet concentrations at least 2/3 times above the normal level and includes platelet-related growth factors. The concept of PRP began in the 1970s in the field of hematology to treat patients with thrombocytopenia. In the 1980s and 1990s, PRP began to be used in surgical procedures such as maxillofacial surgery and plastic surgery. Since then, PRP had been used in orthopedic procedures, cardiac surgery, sports injuries, plastic surgery, gynecology, urology, and more recently in medical esthetics. Areas covered: This review analyzes the mechanisms of action, current indications, clinical evidence, safety and future directions of PRP in the management of various medical conditions. The literature search methodology included using medical subject headings terms to search in PubMed. Articles used were screened and critically appraised by the coauthors of this review. Expert Opinion: Platelet-rich plasma is a therapeutic option used to treat many medical conditions. PRP could be used alone or in combination with other procedures. The effectiveness and safety of PRP has been demonstrated in many medical scenarios, however there is limited availability of large randomized clinical trials.
Collapse
Affiliation(s)
- Shyla Gupta
- Department of Medicine, Queen's University , Kingston, ON, Canada
| | | | | |
Collapse
|
34
|
Coheña-Jiménez M, Pabón-Carrasco M, Pérez Belloso AJ. Comparison between customised foot orthoses and insole combined with the use of extracorporeal shock wave therapy in plantar fasciitis, medium-term follow-up results: A randomised controlled trial. Clin Rehabil 2020; 35:740-749. [PMID: 33233945 DOI: 10.1177/0269215520976619] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the clinical results of custom-made foot orthoses versus placebo flat cushioning insoles combined with an extracorporeal shock wave therapy on pain and foot functionality in patients with plantar fasciitis. DESIGN AND SETTING A randomised controlled clinical trial with follow-up at six months. Faculty of Podiatry and Centre Clinical private of Physiotherapy, Seville, Spain. SUBJECTS AND INTERVENTIONS Patients with plantar fasciitis were randomly assigned to either group A (n = 42), which received custom-made foot orthoses, or group B (n = 41), which received placebo insoles. All the participants received active extracorporeal shock wave therapy including stretching exercises. Recruitment period was from Mach 2019 to July 2020. MAIN MEASUREMENTS The main outcome was foot pain, measured by visual analogue scale and the secondary outcome measures were recorded by Roles and Maudsley scores respectively, at the beginning and at one week, one month and six months. RESULTS Eighty-eight patients were assessed for eligibility. Eighty-three patients were recruited and randomised. This study showed significant differences between both groups according to the visual analogue scale. In control group, the difference was at baseline (P 0.01) and, in the experimental group was at the one- and six-month follow-up (P 0.001). The mean (SD) visual analogue scale at baseline were Control group 6.31 (1.69) and Experimental group 5.27 (1.64); and at six months were 7.52 (3.40) and 3.29 (4.26), respectively. The custom-made foot orthosis was perceived as 'good' (85%) and 'excellent' (97.5%) at medium-long term. CONCLUSION Wearing a custom-made foot orthosis leads to a improvement in patients with plantar fasciitis; it reduced foot pain and improved foot functionality.
Collapse
|
35
|
Seligman DAR, Dawson D, Streiner DL, Seligman DJ, Davis A. Treating Heel Pain in Adults: A Randomized Controlled Trial of Hard vs Modified Soft Custom Orthotics and Heel Pads. Arch Phys Med Rehabil 2020; 102:363-370. [PMID: 33217374 DOI: 10.1016/j.apmr.2020.10.124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 10/03/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study compared the effectiveness of soft vs hard orthotics in treating heel pain and plantar fasciitis in adults. It also compared the level of function after orthotic use, cost, and number of visits for orthotics and explored whether age was a factor in orthotic effectiveness. DESIGN Randomized controlled trial. Before randomization, patients were stratified by age (younger vs older adults) in blocks of 4 to ensure that there were an equal number of participants in each group (soft vs hard orthotics). SETTING An orthotic clinic in a community-based hospital and a private orthotic clinic. PARTICIPANTS The participants were adults aged 18 years or older (N=44) with heel pain and plantar fasciitis. INTERVENTION Participants received hard or soft customized orthotics. MAIN OUTCOME MEASURES Participants rated their pain intensity and pain interference before and after orthotic use using subscales from the Brief Pain Inventory. Function was similarly measured using the Late Life Function and Disability Instrument: Function component. Analyses of age, cost, and number of visits were also compared. RESULTS There was a reduction in pain intensity (P=.010) and pain interference (P<.001) but no change in function over time (P=.333), and no difference between the groups who received hard vs soft orthotics. Age had no effect on orthotic effectiveness. Soft orthotics were less expensive (P<.0001) and required fewer visits for fabrication (P<.0001). CONCLUSION Both soft and hard orthotics provided effective pain relief, but soft orthotics are less expensive.
Collapse
Affiliation(s)
- Deborah A R Seligman
- Department of Occupational Therapy, Baycrest, Toronto, Ontario, Canada; Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada; Orthotics Clinic, Toronto, Ontario, Canada.
| | - Deirdre Dawson
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada; Rotman Research Institute, Baycrest, University of Toronto, Toronto, Ontario, Canada
| | - David L Streiner
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada; St. Joseph's Healthcare, Hamilton, Ontario, Canada
| | - David J Seligman
- Faculty of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Aileen Davis
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Physical Therapy and Surgery, Rehabilitation Science Institute, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
36
|
Kandil MI, Tabl EA, Elhammady AS. Prospective Randomized Evaluation of Local Injection of Allogeneic Growth Factors in Plantar Fasciitis. Foot Ankle Int 2020; 41:1335-1341. [PMID: 32755237 DOI: 10.1177/1071100720939066] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the efficacy and safety of injection of allogeneic growth factors in patients with plantar fasciitis. METHODS This study included 150 patients who were randomly divided into 2 equal groups; the patients were locally injected with allogeneic growth factors (GFs) (treatment group) or with saline 0.9% (control group). The patients were assessed using visual analog scale (VAS) and Foot Function Index-Revised short form (FFI-Rs) scores preinjection and 1, 3, 6, and 12 months postinjection. The patients were questioned about their satisfaction. Any adverse effects were recorded. RESULTS At baseline, there was no significant difference between both groups regarding the mean VAS and FFI-Rs scores. At 3-month follow-up, the reduction in mean VAS score was 87% in the treatment group and 55% in the control group (P < .001), and the reduction in mean FFI-Rs score was 62% in the treatment group and 40% in the control group (P < .001). Treatment group and study visit were significant factors affecting both VAS and FFI-Rs scores. Overall, 92% were satisfied in the treatment group, and 78.2% in the control group. Postinjection pain occurred in 5 patients in the treatment group. CONCLUSION This study provides Level I evidence regarding the efficacy and safety of allogeneic GF injection in patients with plantar fasciitis. However, additional studies are needed to evaluate their adverse effects, immunogenicity, and microbiological safety. LEVEL OF EVIDENCE Level I, prospective randomized controlled case series.
Collapse
Affiliation(s)
- Mahmoud Ibrahim Kandil
- Orthopedic Surgery, Department of Orthopaedics and Traumatology, Faculty of Medicine, Benha University, Benha, Qalyubia, Egypt
| | - Eslam Abdelshafi Tabl
- Orthopedic Surgery, Department of Orthopaedics and Traumatology, Faculty of Medicine, Benha University, Benha, Qalyubia, Egypt
| | - Adel Samy Elhammady
- Orthopedic Surgery, Department of Orthopaedics and Traumatology, Faculty of Medicine, Benha University, Benha, Qalyubia, Egypt
| |
Collapse
|
37
|
Mohammed W, Farah S, Nassiri M, McKenna J. Therapeutic efficacy of platelet-rich plasma injection compared to corticosteroid injection in plantar fasciitis: A systematic review and meta-analysis. J Orthop 2020; 22:124-134. [PMID: 32336895 PMCID: PMC7177161 DOI: 10.1016/j.jor.2020.03.053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 03/26/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND This study summarizes all literature assessing the long term effects of platelet-rich plasma (PRP) injection compared to corticosteroid injection to relieve pain and improve function in Plantar Fasciitis patients. MATERIALS AND METHODS This is a PRISMA compliant systematic review of 5 databases and include a meta-analysis of Randomized Controlled Trial data comparing the two injections. RESULTS Ten prospective trials were included with total number of 543 participants. The PRP group had significantly better pain scores at 3 months and 6 months follow-up. CONCLUSION PRP injections provide better pain relief, compared to corticosteroids, in patients with plantar fasciitis.
Collapse
Affiliation(s)
- Wafi Mohammed
- Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| | - Salma Farah
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Johnny McKenna
- Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| |
Collapse
|
38
|
Toral Guisasola I, Formigo Couceiro J, Alonso Bidegain M. [Selective ultrasound-guided hydrodissection of gastrocnemius nerve branch after post-surgical entrapment: Apropos of a case]. Rehabilitacion (Madr) 2020; 54:292-295. [PMID: 32680689 DOI: 10.1016/j.rh.2020.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 06/11/2023]
Abstract
Chronic or recalcitrant plantar fasciitis is a cause of persistent plantar pain. These cases are usually resistant to conventional treatments consisting of exercises, orthoses, shock waves and infiltrations and require a surgical approach. Proximal medial gastrocnemius release is a surgical option that provides satisfactory results, but is not free of complications, which include injuries and nerve entrapment. We report the first published case of symptomatic medial gastrocnemius branch entrapment in the post-surgical scar of a tenotomy for the treatment of recalcitrant plantar fasciitis. We propose ultrasound-guided hydrodissection with local anesthetic as a treatment with promising results.
Collapse
Affiliation(s)
- I Toral Guisasola
- Servicio de Medicina Física y Rehabilitación, Complexo Hospitalario Universitario de A Coruña, A Coruña, Galicia, España.
| | - J Formigo Couceiro
- Servicio de Medicina Física y Rehabilitación, Complexo Hospitalario Universitario de A Coruña, A Coruña, Galicia, España
| | - M Alonso Bidegain
- Servicio de Medicina Física y Rehabilitación, Complexo Hospitalario Universitario de A Coruña, A Coruña, Galicia, España
| |
Collapse
|
39
|
Wang W, Liu S, Liu Y, Zang Z, Zhang W, Li L, Liu Z. Efficacy of acupuncture versus sham acupuncture or waitlist control for patients with chronic plantar fasciitis: study protocol for a two-centre randomised controlled trial. BMJ Open 2020; 10:e036773. [PMID: 32978188 PMCID: PMC7520861 DOI: 10.1136/bmjopen-2020-036773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Plantar fasciitis (PF) is reported to be the most common cause of plantar heel pain. Acupuncture has been used for patients experiencing PF, but evidence of the efficacy of acupuncture on PF is limited. The primary objective of this trial is to compare combined acupuncture and sham acupuncture (SA) versus waitlist control for improving the level of pain experienced by patients suffering from chronic PF. METHODS AND ANALYSIS This will be a two-centre, parallel-group, sham and no-treatment controlled, assessor-blinded randomised trial. We will randomly allocate 120 participants with chronic PF to acupuncture, SA and waitlist control groups at a ratio of 2:1:1. Participants in the acupuncture and SA groups will receive a 30 min acupuncture or SA treatment for a total of 12 sessions over 4 weeks, with a 12-week follow-up. Participants in the waitlist control group will not undergo treatment for a period of 16 weeks but instead will have the option of 4 weeks (12 sessions) of acupuncture free of charge at the end of the follow-up period. The primary outcome will be the treatment response rate 4 weeks after randomisation, assessed as a minimum of 50% improvement in the worst pain intensity during the first steps in the morning compared with the baseline. All analyses will be performed with a two-sided p value of <0.05 considered significant following the intention-to-treat principle. ETHICS AND DISSEMINATION The study has been approved by the Ethical Committee of the Guang'anmen Hospital, China Academy of Chinese Medical Sciences (approval no. 2019-210-KY). The results will be disseminated through presentation at a peer-reviewed medical journal, the relevant conferences and scientific meetings. TRIAL REGISTRATION NCT04185259.
Collapse
Affiliation(s)
- Weiming Wang
- Acupuncture and Moxibustion Department, China Academy of Traditional Chinese Medicine Guang'anmen Hospital, Xicheng District, China
| | - Sixing Liu
- School of Acupuncture-Moxibustion and Tuina, Guizhou University of Traditional Chinese Medicine, Guiyang City, Guizhou, China
| | - Yan Liu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhiwei Zang
- Department of Acupuncture, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
| | - Weina Zhang
- Acupuncture and Moxibustion Department, China Academy of Traditional Chinese Medicine Guang'anmen Hospital, Xicheng District, China
| | - Liang Li
- Department of Ultrasound, China Academy of Chinese Medical Sciences Guanganmen Hospital, Xicheng District, Beijing, China
| | - Zhishun Liu
- Acupuncture and Moxibustion Department, China Academy of Traditional Chinese Medicine Guang'anmen Hospital, Xicheng District, China
| |
Collapse
|
40
|
Lee DO, Yoo JH, Cho HI, Cho S, Cho HR. Comparing effectiveness of polydeoxyribonucleotide injection and corticosteroid injection in plantar fasciitis treatment: A prospective randomized clinical study. Foot Ankle Surg 2020; 26:657-661. [PMID: 31521520 DOI: 10.1016/j.fas.2019.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/23/2019] [Accepted: 08/15/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study aimed to compare the efficacy and safety of polydeoxyribonucleotide (PDRN) injection and corticosteroid injection for plantar fasciitis. METHODS This study included 44 patients with plantar fasciitis, randomly allocated to the PDRN and corticosteroid groups. Evaluation using the visual analogue scale (VAS) pain score and Manchester-Oxford foot questionnaire (MOXFQ) was conducted at baseline, 1, 2, 6weeks and 6months. The thickness and echogenicity of the plantar fascia in ultrasonography and complications were recorded. RESULTS Corticosteroid injection elicited more pain relief than did PDRN injection at 2 (p=0.010) and 6weeks (p=0.016); however, it showed no superiority at 6months (p=0.523). MOXFQ showed similar outcomes. The thickness and echogenicity did not differ between groups and no complications were reported in either group. CONCLUSIONS We demonstrated that PDRN injection could be an effective and safe option for plantar fasciitis and was comparable to corticosteroid injection after 6months follow up. LEVEL OF EVIDENCE II, comparative study.
Collapse
Affiliation(s)
- Dong-Oh Lee
- Department of Orthopedic Surgery, Myongji Hospital, Hanyang University College of Medicine, 697-24 Hwajung-dong, Deokyang-gu, Goyang-si, Gyeonggi-do 10475, Republic of Korea.
| | - Jeong-Hyun Yoo
- Department of Orthopedic Surgery, Myongji Hospital, Hanyang University College of Medicine, 697-24 Hwajung-dong, Deokyang-gu, Goyang-si, Gyeonggi-do 10475, Republic of Korea.
| | - Hyung-In Cho
- Department of Orthopedic Surgery, Myongji Hospital, Hanyang University College of Medicine, 697-24 Hwajung-dong, Deokyang-gu, Goyang-si, Gyeonggi-do 10475, Republic of Korea.
| | - Soonghwan Cho
- Department of Orthopedic Surgery, Myongji Hospital, Hanyang University College of Medicine, 697-24 Hwajung-dong, Deokyang-gu, Goyang-si, Gyeonggi-do 10475, Republic of Korea.
| | - Hyung Rae Cho
- Department of Anesthesiology and Pain Medicine, Myongji Hospital, Hanyang University College of Medicine, 697-24 Hwajung-dong, Deokyang-gu, Goyang-si, Gyeonggi-do 10475, Republic of Korea.
| |
Collapse
|
41
|
Siriphorn A, Eksakulkla S. Calf stretching and plantar fascia-specific stretching for plantar fasciitis: A systematic review and meta-analysis. J Bodyw Mov Ther 2020; 24:222-232. [PMID: 33218515 DOI: 10.1016/j.jbmt.2020.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 06/08/2020] [Accepted: 06/13/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Plantar fasciitis (PF) is the most common cause of heel pain. A calf stretching (CS) and a plantar fascia-specific stretching (PFSS) are two stretching techniques commonly administered by health care providers. OBJECTIVE To evaluate the literature on the application of these two stretching techniques in the treatment of PF and investigate their effectiveness and efficacy. METHOD A search of PubMed, Web of Sciences, PEDro, CINHAL and Scopus was conducted. Studies that applied stretching as a co-intervention were excluded. The risk of bias was assessed to determine the internal validity of the included trials. The GRADE approach was adopted to determine the overall quality. Pooled analysis was performed to determine the treatment effects of CS and PFSS in terms of the mean difference in the visual analog scale pain score. RESULTS Eight articles were found that represented randomized controlled trial and met the inclusion criteria. There was very low-quality evidence that the combined CS and PFSS was less effective in the short term than the other therapies. Comparison between CS and PFSS revealed moderate quality evidence for a larger effect of pain score reduction for PFSS treatment over CS, while very low-quality evidence supported that combined CS and PFSS or CS alone was superior to sham stretching. CONCLUSION There was moderate to very low-quality evidence of the effectiveness of stretching for PF. The treatment effect of stretching was large and comparable to other therapies. Future trials of higher quality are needed to clarify findings or to confirm findings.
Collapse
Affiliation(s)
- Akkradate Siriphorn
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand.
| | - Sukanya Eksakulkla
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand
| |
Collapse
|
42
|
Serino J, Kunze KN, Jacobsen SK, Morash JG, Holmes GB, Lin J, Lee S, Hamid KS, Bohl DD. Nuclear Medicine for the Orthopedic Foot and Ankle Surgeon. Foot Ankle Int 2020; 41:612-623. [PMID: 32141327 DOI: 10.1177/1071100720910422] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Nuclear medicine has been widely applied as a diagnostic tool for orthopedic foot and ankle pathology. Although its indications have diminished with improvements in and the availability of magnetic resonance imaging, nuclear medicine still has a significant and valuable role. The present article offers a comprehensive and current review of the most common nuclear imaging modalities for the orthopedic foot and ankle surgeon. Methods discussed include bone scintigraphy, gallium citrate scintigraphy, labeled-leukocyte scintigraphy, and single-photon emission computed tomography (SPECT). We review the indications and utility of these techniques as they pertain to specific foot and ankle conditions, including osteomyelitis, stress fractures, talar osteochondral lesions, complex regional pain syndrome, oncology, plantar fasciitis, and the painful total ankle arthroplasty. We conclude with a discussion of our approach to nuclear medicine with illustrative cases. Level of Evidence: Level V, expert opinion.
Collapse
Affiliation(s)
- Joseph Serino
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Kyle N Kunze
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Stephen K Jacobsen
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Joel G Morash
- Department of Orthopaedic Surgery, Dalhouse University, Halifax, Nova Scotia, Canada
| | - George B Holmes
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Johnny Lin
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Simon Lee
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Kamran S Hamid
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Daniel D Bohl
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
43
|
Gamba C, Serrano-Chinchilla P, Ares-Vidal J, Solano-Lopez A, Gonzalez-Lucena G, Ginés-Cespedosa A. Proximal Medial Gastrocnemius Release Versus Open Plantar Fasciotomy for the Surgical Treatment in Recalcitrant Plantar Fasciitis. Foot Ankle Int 2020; 41:267-274. [PMID: 31808359 DOI: 10.1177/1071100719891979] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Plantar fasciitis is a common cause of foot pain. If conservative treatment fails, there is no consensus as to the best surgical management for recalcitrant plantar fasciitis (RPF). The aim of this study was to compare the results obtained from proximal medial gastrocnemius release (PMGR) with those obtained from open plantar fasciotomy (OPF) in terms of pain, satisfaction, health-related quality of life, and American Orthopaedic Foot & Ankle Society (AOFAS) score. METHODS This is a prospective randomized trial conducted between 2012 and 2016. Patients with RPF for at least 9 months were included. Diagnosis was clinically made. The exclusion criteria were neuropathic heel pain; a history of previous foot fracture, surgery, or deformity; rheumatoid arthritis; or the need for long-term analgesic administration. After ruling out other conditions with magnetic resonance or ultrasound imaging, patients were randomized to be operated on with OPF or PMGR independently of the Silfverskjold test. Follow-up was carried out for up to 1 year. The AOFAS, visual analog scale (VAS) for pain, SF-36, and Likert scale for satisfaction were used to evaluate the results obtained. The analysis was done with 21 patients in the OPF group and 15 in the PMGR group. The demographic data (age, sex, body mass index, duration of symptoms, and positivity to the Silfverskjold test) of the groups were comparable. RESULTS No differences were found in terms of the AOFAS (P = .24), VAS (P = .14), or any item of the SF-36. Satisfaction was very good in 85.8% of the PMGR group and 89.5% of the OPF group (P = .27). Faster recovery was observed in the PMGR group. CONCLUSION OPF and PMGR provided good results for patients with RPF. Neither was superior to the other relative to pain, AOFAS score, satisfaction, or the SF-36. We recommend PMGR as the first option in RPF surgical management in order to avoid potential biomechanical complications related to OPF. LEVEL OF EVIDENCE Level I, therapeutic randomized controlled trial.
Collapse
Affiliation(s)
- Carlo Gamba
- Orthopaedic Department, Hospital del Mar, Universitat Autonoma Barcelona (UAB), Barcelona, Spain.,Orthopaedic Department, Hospital de la Santa Creu I Sant Pau, Universitat Autonoma Barcelona (UAB), Barcelona, Spain
| | | | - Jesus Ares-Vidal
- Department of Radiology and Radiodiagnostic, Hospital del Mar, Barcelona, Spain
| | | | - Gemma Gonzalez-Lucena
- Orthopaedic Department, Hospital del Mar, Universitat Autonoma Barcelona (UAB), Barcelona, Spain
| | - Alberto Ginés-Cespedosa
- Orthopaedic Department, Hospital del Mar, Universitat Autonoma Barcelona (UAB), Barcelona, Spain
| |
Collapse
|
44
|
Abstract
Each year increasing numbers of people participate in a wider variety of athletic endeavors. Unlike previous generations, many patients remain in these activities later into their lives, some well beyond retirement. As the population ages and their activities continue, they are subject to injury of various forms affecting all aspects of their bodies.
Collapse
Affiliation(s)
| | - Christina Lin
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA
| |
Collapse
|
45
|
YALÇIN Ü. Plantar Fasiit Tedavisinde Trombosit Zengin Plazma ve Ekstrakorporeal Şok Dalga Tedavisinin Etkinliğinin Karşılaştırılması. ACTA MEDICA ALANYA 2020. [DOI: 10.30565/medalanya.566188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
46
|
Clinical efficacy of platelet-rich plasma in the treatment of lateral epicondylitis: a systematic review and meta-analysis of randomized placebo-controlled clinical trials. Clin Rheumatol 2020; 39:2255-2265. [DOI: 10.1007/s10067-020-05000-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/10/2020] [Accepted: 02/14/2020] [Indexed: 12/12/2022]
|
47
|
Leggit J, Mark R, Hulsopple C, Carey PM, Alisangco JB. Disorders of the Lower Extremity. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_118-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
48
|
Latt LD, Jaffe DE, Tang Y, Taljanovic MS. Evaluation and Treatment of Chronic Plantar Fasciitis. FOOT & ANKLE ORTHOPAEDICS 2020; 5:2473011419896763. [PMID: 35097359 PMCID: PMC8564931 DOI: 10.1177/2473011419896763] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Plantar fasciitis is the most common cause of chronic heel pain in adults, affecting both young active patients and older sedentary individuals. It results from repetitive stress to the plantar fascia at its origin on the medial tubercle of the calcaneus and is often associated with gastrocnemius tightness. The diagnosis can be made clinically with a focused history and physical examination; imaging is reserved for atypical presentations and those that do not respond to initial treatment. The most common presenting symptom is aching plantar heel pain, which is worst with first step in the morning or after periods of rest. Diagnosis is confirmed with point tenderness at the origin of the plantar fascia on the medial tubercle of the calcaneus. Initial treatment consists of activity modification, anti-inflammatory medication, gastrocnemius and plantar fascia stretching, and an in-shoe orthosis that lifts and cushions the heel. These nonoperative treatments lead to complete resolution of pain in 90% of patients but can take 3-6 months. Patients who remain symptomatic despite a 6-month trial of nonoperative therapy may be considered for minimally invasive treatment or surgery. Platelet-rich plasma injections and therapeutic ultrasound are among a number of minimally invasive treatments that stimulate the body's healing response. Corticosteroid injections temporarily relieve pain, but may increase the risk of plantar fascia rupture and fat pad atrophy. Botulinum toxin injections relax the calf muscles, which decreases the stress in the plantar fascia. Operative treatments include gastrocnemius recession and medial head of gastrocnemius release, which decrease the stress on the plantar fascia and partial planter fasciotomy, which stimulates a healing response. LEVEL OF EVIDENCE Level V, expert opinion.
Collapse
Affiliation(s)
| | - David Eric Jaffe
- OrthoArizona–Arizona Bone and Joint Specialists, Scottsdale, AZ, USA
| | | | | |
Collapse
|
49
|
MacRae CS, Roche AJ, Sinnett TJ, O'Connell NE. What is the evidence for efficacy, effectiveness and safety of surgical interventions for plantar fasciopathy? Protocol for a systematic review. BMJ Open 2019; 9:e031407. [PMID: 31628127 PMCID: PMC6803112 DOI: 10.1136/bmjopen-2019-031407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Plantar fasciopathy (PF) is a degenerative condition of the plantar fascia, secondary to repetitive overloading. For the majority, PF is self-limiting with greater than 80% of those affected gaining complete resolution within 1 year. However, persistent symptoms develop in approximately 10% of cases. Clinical practice guidelines for first-line treatment of PF recommend conservative management. For people with persistent symptoms that have not resolved following a trial of 6-12 months of conservative management, surgery may be offered. However, to date there are no systematic reviews of the effectiveness of the various surgical procedures for PF. We aim to systematically review quantitative studies assessing the effectiveness of surgical interventions in the management of PF. METHODS AND ANALYSIS We will search for all published and unpublished randomised clinical trials evaluating surgical interventions in the management of PF. Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE (OVID), EMBASE (OVID), Web of Science (ISI) and Google Scholar will be searched without restrictions on date or language of publication. Inclusion criteria will include people over 18 years, diagnosed by clinical examination with PF, or with an alternative diagnostic label (eg, plantar fasciitis, plantar heel pain, plantar fasciosis). The primary outcomes are changes in pain severity/intensity for first-step pain, and incidence and nature of adverse events. Secondary outcomes include foot and ankle-related disability/function, health-related quality of life, cost-effectiveness, changes in other reported measures of pain (eg, overall pain) and medication use. Outcomes will be assessed (1) short term (≤3 months after intervention), (2) medium term (>3 months to ≤6 months after intervention) or (3) long term (>6 months to ≤2 years after treatment). All data extraction will be performed by at least two independent reviewers on the basis of a priori developed extraction form. Where adequate data are found meta-analysis will be used to combine the results of studies for all core comparisons and outcomes using random effects models. Overall certainty of the evidence for each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION This systematic review does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at appropriate conferences. PROSPERO REGISTRATION NUMBER CRD42019133563.
Collapse
Affiliation(s)
- C Siân MacRae
- Department of Clinical Sciences, Brunel University London, Uxbridge, UK
- Therapy Services, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Andrew J Roche
- Foot and Ankle Unit, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Tim J Sinnett
- Foot and Ankle Unit, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Neil E O'Connell
- Department of Clinical Sciences, Brunel University London, Uxbridge, UK
| |
Collapse
|
50
|
Çatal B, Keskinbora M, Keskinöz EN, Tümentemur G, Azboy İ, Demiralp B. Percutaneous Plantar Fascia Release With Needle: Anatomic Evaluation with Cadaveric Specimens. J Foot Ankle Surg 2019; 58:842-846. [PMID: 31130478 DOI: 10.1053/j.jfas.2018.12.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Indexed: 02/03/2023]
Abstract
Percutaneous plantar fascia release with needle is a novel procedure for the treatment of plantar fasciitis. The objective of this cadaveric study is to perform an anatomic evaluation of the percutaneous plantar fascia release method using a conventional hypodermic needle. In this study, we used 14 fresh-frozen cadaveric trans-tibial amputation specimens. Percutaneous plantar fasciotomy with a conventional hypodermic needle was performed. After a proper dissection, the width of the plantar fascia, the thickness of the medial border, and the width of the cut segment were measured and recorded. Any muscle damage on the flexor digitorum brevis and damaged area depth were recorded. Any damage on the lateral plantar nerve and the first branch of the lateral plantar nerve, also known as Baxter's nerve, and their distance to fasciotomy were also recorded. Mean width (± standard deviation) of the plantar fascia was measured as 20.34 ± 4.25 mm. The mean thickness of the medial border of the plantar fascia was 3.04 ± 0.54 mm. Partial fasciotomy was performed in all cadavers with 49.47% ± 7.25% relative width of the plantar fascia. No lateral plantar nerve, or its first branch Baxter's nerve, was damaged, and the mean distance from the deepest point of the fasciotomy up to the Baxter's nerve was 8.62 ± 2.62 mm. This cadaveric study demonstrated that partial plantar fasciotomy can be achieved via percutaneous plantar fascia release with a conventional hypodermic needle without any nerve damage.
Collapse
Affiliation(s)
- Bilgehan Çatal
- Orthopedic Surgeon, Department of Orthopedic Surgery, Medipol Koşuyolu Hospital, İstanbul, Turkey.
| | - Mert Keskinbora
- Orthopedic Surgeon, Department of Orthopedic Surgery, Medipol Koşuyolu Hospital, İstanbul, Turkey
| | - Elif Nedret Keskinöz
- Associate Registrar, Department of Anatomy, Acıbadem University Medical School, İstanbul, Turkey
| | - Gamze Tümentemur
- Associate Registrar, Department of Anatomy, Acıbadem University Medical School, İstanbul, Turkey
| | - İbrahim Azboy
- Associate Professor, Department of Orthopedic Surgery, Medipol University Medical School, İstanbul, Turkey
| | - Bahtiyar Demiralp
- Professor, Department of Orthopedic Surgery, Güven Hospital, Ankara, Turkey
| |
Collapse
|