Kronik Plantar Fasiit Tedavisinde Üç Farklı Tedavi Yönteminin Kıyaslanması: Kortikosteroid Enjeksiyonu, Ekstrakorporeal Şok Dalga Tedavisi ve Radyofrekans Sinir Ablasyonu

Amaç: Bu çalışmada kronik plantar fasiit (PF) tedavisinde kullanılan üç farklı popüler konservatif tedavi yöntemi olan kortikosteroid enjeksiyonu (KSE), ekstrakorporeal şok dalga tedavisi (ESWT) ve radyofrekans sinir ablasyonu (RFSA) tedavi yöntemlerinin klinik ve fonksiyonel sonuçlarının karşılaştırması amaçlanmıştır.Gereç ve Yöntemler: Bu retrospektif çalışmaya diğer konservatif tedavi yöntemlerine dirençli olan kronik PF'li hastalar dahil edildi. Ocak 2017 ile Şubat 2019 arasında konservatif tedavi yöntemleriyle tedavi edilmiş olan kronik PF tanılı tüm hastalar incelendi. Uygunluk kriterleri ile uyumlu olan ve KSE, ESWT veya RFSA yöntemlerinden biri ile tedavi edilen kırk sekiz hasta çalışmaya dahil edildi. Hastaların klinik ve fonksiyonel değerlendirmeleri tedaviden hemen önce ve son seansın 6. ve 12. haftalarında, Amerikan Ortopedik Ayak ve Ayak Bileği Birliği (AOFAS) skorlama sistemi ve görsel analog skala (VAS) ile yapıldı.Bulgular: Gruplar arasında hem tedavi öncesi hem de 6. Hafta için VAS skorları bakımından istatistiksel olarak anlamlı düzeyde bir farklılık vardı (her iki p<0,001), ancak 12. hafta VAS skorları bakımından gruplar arasında istatistiksel olarak anlamlı bir farklılık yoktu (p=0,436). Ayrıca üç grup arasında, tedavi öncesi, 6. ve 12. hafta değerlendirmelerindeki AOFAS skorları açısından da istatistiksel olarak anlamlı bir fark yoktu (sırasıyla p=0,076, p=0,081, p=0,478).Sonuç: Üç tedavi yöntemi de kronik PF tedavisinde önemli iyileşmeler göstermesine rağmen, son takip döneminde bu tedavilerin etkinlikleri açısından aralarında anlamlı bir fark bulunamamıştır.

Anahtar Kelimeler:

Kortikosteroidler, ekstrakorporeal şok dalga tedavisi, plantar fasiit, ablasyon teknikleri

Comparison of Three Different Treatment Modalities in the Treatment of Chronic Plantar Fasciitis: Corticosteroid Injection, Extracorporeal Shock Wave Therapy and Radiofrequency Nerve Ablation

Aim: In this study, it was aimed to compare the clinical and functional outcomes of three popular conservative treatment options in the treatment of chronic plantar fasciitis (PF): corticosteroid injection (CSI), extracorporeal shock wave therapy (ESWT) and radiofrequency nerve ablation (RFNA).Material and Methods: Patients with chronic PF refractory to other conservative treatment methods were included in this retrospective study. From January 2017 to February 2019, all the patients with the diagnosis of chronic PF who were treated with conservative treatment modalities were evaluated. Forty eight patients who met our eligibility criteria and treated either with CSI, ESWT or RFNA methods were included in the study. Clinical and functional assessments of the patients were done by American Orthopaedic Foot and Ankle Society (AOFAS) scoring system and Visual Analogue Scale (VAS) just before the treatment, at 6th and at 12th weeks of the last session.Results: There was a statistically significant difference in terms of VAS scores between the groups both for before treatment and for 6th week (both p<0.001), but there was not a statistically significant difference between the groups in terms of VAS scores at 12th week (p=0.436). Also, there was not a statistically significant difference between the three groups in terms of AOFAS scores before treatment, 6th and 12th week assessments (p=0.076, p=0.081, p=0.478 respectively).Conclusion: Although the three treatment modalities showed significant improvements in the chronic PF treatment, no differences were found among effectiveness of them at the final follow-up period.

Keywords:

Corticosteroids, extracorporeal shockwave therapy, plantar fasciitis, ablation techniques,

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