Ultrasound-Guided Percutaneous Radiofrequency Lesioning When Treating Recalcitrant Plantar Fasciitis: Clinical Results.
OBJECTIVE
We evaluated the effects of ultrasound (US)-guided percutaneous radiofrequency thermal lesioning (RTL) and the impact of obesity when treating patients with recalcitrant plantar fasciitis.


METHODS
30 consecutive patients were enrolled. The visual analog scale (VAS), American Orthopedic Foot-Ankle Society (AOFAS) Ankle-Hindfoot Score, and plantar fascia thickness measured using US were recorded at baseline and at follow-up 1, 3, 6, and 12 months after surgery under local anesthesia.


RESULTS
12 patients in the obese (BMI ≥ 30 kg/m(2)) group and 18 patients in the non-obese group. There were significant postoperative decreases in VAS scores and in fascial thickness, and an increase in the AOFAS scores (all p < 0.001). The obese group showed delayed pain and functional improvement within the first 3 months after the index procedure (p < 0.01). Significant pain reduction and functional improvement were apparent earlier (after 1 month, p < 0.001) in the non-obese group than in the obese group (after 3 months, p < 0.05). Fascia thickness was positively correlated with the VAS score and negatively correlated with the AOFAS score (both p < 0.001).


CONCLUSIONS
US should be regarded as a useful objective tool to guide RTL and to monitor the effectiveness of treatment. US-guided percutaneous RTL for recalcitrant PF is a minimally invasive treatment option that yields satisfactory results. Therefore, it should at least be considered before using more invasive procedures. Moreover, obesity leads to delayed improvement but does not affect overall outcome after 12 months. Plantar fascial thickness was correlated with VAS and AOFAS scores.
Department of Orthopaedics, National Cheng Kung University Hopistal, Tainan, Taiwan.
P T
PT
Wu
Division of Neurosurgery, Department of Surgery, National Cheng Kung University Hopistal, Tainan, Taiwan.
J S
JS
Lee
Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
K C
KC
Wu
Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
T T
TT
Wu
Department of Orthopaedics, Tainan Municipal Hospital, Tainan, Taiwan.
C J
CJ
Shao
Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
F W
FW
Liang
Chern Tai-Chung's Orthopedics Clinic, Tainan, Taiwan.
T C
TC
Chern
Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
F C
FC
Su
Department of Orthopaedics, National Cheng Kung University Hopistal, Tainan, Taiwan.
I M
IM
Jou
D004867:Equipment Design / Q000295:instrumentation; D005205:Fascia / Q000000981:diagnostic imaging; D036981:Fasciitis, Plantar / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012008:Recurrence; D013223:Statistics as Topic; D018084:Ultrasonography, Interventional / Q000295:instrumentation / Q000379:methods*; D064232:Visual Analog Scale