Shock wave therapy for chronic proximal plantar fasciitis
Shock wave therapy for chronic proximal plantar fasciitis
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DOI：
10.1097/00003086-200106000-00007
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发表时间：
2001-06-01
影响因子：
4.2
通讯作者：
Marlow, M
中科院分区：
文献类型：
--
作者：
Ogden, JA;Alvarez, R;Marlow, M
302 名患有近端足底筋膜炎引起的慢性足跟痛的患者参加了一项研究，以评估电动液压产生的体外冲击波的治疗效果。症状持续 6 个月至 18 年。每位接受治疗的患者在接受本研究之前均满足多项纳入和排除标准，该研究已获得美国食品和药物管理局批准，作为冲击波疗法治疗该疾病疗效的随机、双盲评估。总体而言，在一次治疗后 3 个月的预定评估期内，与接受安慰剂治疗的患者相比，接受治疗的患者中有 56% 的患者在所有四项评估标准上均获得成功。这种差异是显着的，并证实了这样一个事实：结果的这种差异具体归因于冲击波治疗，而不是由病情的自然史引起的任何自然改善。目前的研究表明，直接应用电动液压产生的冲击波将足底筋膜插入跟骨是一种安全有效的非手术方法，用于治疗慢性顽固性足跟疼痛综合征，该综合征已存在至少 6 个月，并且其他常用非手术疗法难以治愈。这项技术使用 OssaTron（瑞士克罗伊茨林根高科技医疗技术公司）提供，已获得美国食品和药物管理局的批准，专门用于治疗慢性近端足底筋膜炎。结果表明，在任何手术选择之前应考虑这种治疗方式，甚至可能优于可的松注射，因为可的松注射具有公认的足底筋膜破裂和症状复发的风险。
Three hundred two patients with chronic heel pain caused by proximal plantar fasciitis were enrolled in a study to assess the treatment effects consequent to administration of electrohydraulicall-generated extracorporeal shock waves. Symptoms had been present from 6 months to 18 years. Each treated patient satisfied numerous inclusion and exclusion criteria before he or she was accepted into this study, which was approved by the Food and Drug Administration as a randomized, double-blind evaluation of the efficacy of shock wave therapy for this disorder. Overall, at the predetermined evaluation period 3 months after one treatment, 56% more of the treated patients had a successful result by all four of the evaluation criteria when compared with the patients treated with a placebo. This difference was significant and corroborated the fact that this difference in the results was specifically attributable to the shock wave treatment, rather than any natural improvement caused by the natural history of the condition. The current study showed that the directed application of electrohydraulic-generated shock waves to the insertion of the plantar fascia onto the calcaneus is a safe and effective nonsurgical method for treating chronic, recalcitrant heel pain syndrome that has been present for at least 6 months and has been refractory to other commonly used nonoperative therapies. This technology, when delivered using the OssaTron (High Medical Technology, Kreuz-lingen, Switzerland), has been approved by the Food and Drug Administration specifically for the treatment of chronic proximal plantar fasciitis, The results suggest that this therapeutic modality should be considered before any surgical options, and even may be preferable to cortisone injection, which has a recognized risk of rupture of the plantar fascia and recurrence of symptoms.