ABSTRACT
Intense therapeutic ultrasound for chronic plantar fasciitis musculoskeletal tissue pain reduction was evaluated in a pivotal clinical trial examining effectiveness, safety, and patient tolerance. In this single-blinded study, 33 patients received 2 treatments that were 4 weeks apart on plantar fascia tissue along with conservative standard of care. Patients were followed for up to 6 months after the first treatment, receiving a physical examination and diagnostic ultrasound at each follow-up visit and completing patient-/subject-reported outcome measure and Foot Function Index surveys. The goal was to reduce overall pain by ≥25% on average and >25% individually. Hypoechoic area changes on diagnostic ultrasound and adverse events were measured. The percentage meeting pain reduction criteria at weeks 4, 8, 12, and 26 were 72%, 81%, 86%, and 79%, respectively. Mean pain scores at each visit were significantly different from baseline (p < .001) at -39%, -49%, -51%, and -44%. Hypoechoic lesions were found in all patients and decreased in size significantly (p < .05) at weeks 8 and 12 (-56% and -67%). Foot Function Index scores declined favorably from baseline (p < .001) at all time points (-32%, -46%, -49%, and -32%). The percentages of patients meeting satisfaction criteria were 72%, 85%, 90%, and 83%. The mean pain score during treatment 1 was 3.4, and during treatment 2, 2.9. Attrition of only 1 patient owing to pain occurred, after treatment 1. No adverse events occurred. Intense therapeutic ultrasound for chronic plantar fasciitis is shown to be effective, safe, and well tolerated in this pivotal clinical trial.
Subject(s)
Fasciitis, Plantar/therapy , Ultrasonic Therapy , Adult , Aged , Aponeurosis/diagnostic imaging , Combined Modality Therapy , Fasciitis, Plantar/diagnostic imaging , Female , Foot Orthoses , Humans , Male , Middle Aged , Patient Reported Outcome Measures , Patient Satisfaction , Physical Examination , Physical Therapy Modalities , Single-Blind Method , Ultrasonography , Visual Analog ScaleABSTRACT
The body's ability to repair injured articular cartilage is poor due to the inherent physiology of cartilage. Joint arthritis, whether through injury or increasing age, is a prevalent condition. Treatment of an articular cartilage injury may include arthroplasty, fusion, or repair. A popular pathway of treatment in a salvageable joint is often to avoid donor site morbidity and place increased effort to reestablish native cartilage with the use of allografts. This article discusses current research on acellular and cellular allografts for articular cartilage restoration.
Subject(s)
Arthroplasty/methods , Cartilage Diseases/surgery , Cartilage, Articular/injuries , Acellular Dermis , Adult , Allografts , Female , Humans , Middle Aged , Transplantation, HomologousABSTRACT
Posterior ankle pain can occur for many reasons. If it is produced by forced plantarflexion of the foot, it is often a result of impingement from an enlarged posterior talar process or an os trigonum. This condition may present in an acute or chronic state. Management is initially nonoperative, but surgical treatments are available. This condition is often seen in athletes, so procedures that limit surgical trauma and allow early return to activity are ideal. An arthroscopic approach for this disorder produces good outcomes with limited complications. Understanding the indications, local anatomy, and surgical technique, allows good, reproducible outcomes.