Ultrasound-Guided Percutaneous Radiofrequency Lesioning When Treating Recalcitrant Plantar Fasciitis: Clinical Results

Abstract

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.

Radiofrequency Thermal Lesioning and Extracorporeal Shockwave Therapy: A Comparison of Two Methods in the Treatment of Plantar Fasciitis

“…1,2,6,7 In addition, structural and biomechanical factors, including pes cavus, pronated foot, and limited plantar flexion range, may cause plantar heel pain. 2,6,7 Approximately 11% to 15% of cases with chronic plantar heel pain require treatment. 15,16 The standard treatment is conservative, 3,11 yielding successful results in 90% to 95% of the cases and proving to be sufficient in many cases.…”

“…Moreover, to the best of our knowledge, BMI is the only variable associated with the extent of disability in patients with plantar fasciitis. 6,7,26 Few studies demonstrated that BMI values above normal were associated with plantar fasciitis. [27][28][29] In most studies, the patients were overweight.…”

“…[27][28][29] In most studies, the patients were overweight. 6,7 Our study population also was considered overweight.…”

“…During percutaneous RTL, most surgeons use a fluoroscope or ultrasound to confirm the location of the electrode. 7,30,31 However, RTL yielded successful results without reconfirming the location of the electrode before lesioning in the treatment of chronic plantar fasciitis. 32,33 Similarly, we performed RTL without any specific preassessment to confirm the location of the electrode.…”

“…2-4 Based on the natural course of the disease, treatment usually is nonsurgical, 1-4 including stretching exercises, braces and orthoses, nonsteroidal anti-inflammatory drugs, steroidal injections, botulinum toxin injection, transcutaneous electrical nerve stimulation, platelet-rich plasma injections, radiofrequency thermal lesioning (RTL), and extracorporeal shockwave therapy (ESWT). 1,2,4-11 Nonsurgical management of the plantar fasciitis is successful in approximately 90% of patients. 3,8,11 Surgical procedures, including the removal or release of the fascia and removal of bone spurs, are indicated if conservative treatment fails after 6 months to 1 year.…”