Sonographically Guided Cryoneurolysis

Friedman, Talia; Richman, Daniel; Adler, Ronald S.

doi:10.7863/jum.2012.31.12.2025

Cited by 46 publications

(14 citation statements)

References 17 publications

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“…Studies took place in United Kingdom (6 studies) [2, 7, 22, 39, 40, 50], Italy (5 studies) [8, 20, 23, 53, 55], United States of America (4 studies) [4, 5, 19, 49], Australia [1, 10], South Korea [52, 54], Spain [6, 41] and Turkey [3, 9] (2 studies each) and South Africa [48] and France [51] (1 study each). Clinical settings represented were Hospital (9 studies) [3, 8, 9, 22, 39, 41, 50, 52, 54], University [2, 6, 19, 20, 23, 48, 56] and Radiology [1, 7, 10, 49, 51, 53, 55] (7 studies each), and Private Practice (2 studies) [4, 5]. The study types consisted of seven RCTs [3, 39–41, 48, 50, 52], and 18 pre/post case series [1, 2, 4–10, 19, 20, 22, 23, 49, 51, 53–55].…”

Section: Resultsmentioning

confidence: 99%

“…The non‐invasive interventions included two mobilisation and manipulation studies [2, 48], two wider footwear and metatarsal padding studies [3, 4], one extracorporeal shockwave therapy (ESWT) study [52] and one orthoses study [50]. The invasive interventions included seven corticosteroid injection studies [1, 3, 22, 39–41, 54], seven sclerosing injection studies [5, 7, 8, 19, 20, 23, 55], three radiofrequency ablation studies [9, 10, 53], two cryoneurolysis studies [49, 51], and one Botox injection study [6]. See Table 2 for the study characteristics and Table 3 for the results of included studies.…”

Section: Resultsmentioning

confidence: 99%

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The effectiveness of non‐surgical interventions for common plantar digital compressive neuropathy (Morton's neuroma): a systematic review and meta‐analysis

Matthews

Hurn

Harding

et al. 2019

Journal of Foot and Ankle Research

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Background Morton’s neuroma (MN) is a compressive neuropathy of the common plantar digital nerve. It is a common compressive neuropathy often causing significant pain which limits footwear choices and weight bearing activities. This paper aims to review non-surgical interventions for MN, to evaluate the evidence base for the clinical management of MN. Methods Electronic biomedical databases (CINAHL, EMBASE, MEDLINE and Cochrane) were searched to January 2018 for studies evaluating the effectiveness of non-surgical interventions for Morton’s neuroma. Outcome measures of interest were treatment success rate (SR) (binary) and pain as measured using 100-point visual analogue scale (VAS) (continuous). Studies with and without control groups were included and were evaluated for methodological quality using the Downs and Black Quality Index. Results from randomised controlled trials (RCT) were compared between-groups, and case series were compared pre- versus post-treatment. Effect estimates are presented as odds ratios (OR) for binary data or mean differences (MD) for continuous data. Random effects models were used to pool effect estimates across studies where similar treatments were used. Heterogeneity was assessed using the I 2 statistic. Results A total of 25 studies met the inclusion criteria, seven RCTs and 18 pre/post case series. Eight different interventions were identified, with corticosteroid or sclerosing injections being the most often reported (seven studies each). Results from a meta-analysis of two RCTs found corticosteroid injection decreased pain more than control on VAS (WMD: -5.3, 95%CI: -7.5 to − 3.2). Other RCTs reported efficacy of: manipulation/mobilisation versus control (MD: -15.3, 95%CI: -29.6 to − 1.0); extracorporeal shockwave therapy versus control (MD: -5.9, 95%CI: -21.9 to 10.1). Treatment success was assessed for extracorporeal shockwave therapy versus control (OR: 0.3, 95%CI: 0.0 to 7.1); and corticosteroid injection vs footwear/padding (OR: 6.0, 95%CI: 1.9 to 19.2). Sclerosing and Botox injections, radiofrequency ablation and cryoneurolysis have been investigated by case series studies, however these were of limited methodological quality. Conclusions Corticosteroid injections and manipulation/mobilisation are the two interventions with the strongest evidence for pain reduction, however high-quality evidence for a gold standard intervention was not found. Although the evidence base is expanding, further high quality RCTs are needed. Electronic supplementary material The online version of this article (10.1186/s13047-019-0320-7) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The effectiveness of non‐surgical interventions for common plantar digital compressive neuropathy (Morton's neuroma): a systematic review and meta‐analysis

Matthews

Hurn

Harding

et al. 2019

Journal of Foot and Ankle Research

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“…MR-guided Morton's neuroma cryoablation has been reported by Cazzato et al as a feasible and tolerated technique with initially promising results requiring further investigation [12]. Friedman and colleagues reported good clinical results from a retrospective study on 20 patients subjected to USguided cryoablation of Morton's neuroma [97].…”

Section: Us-guided Ethanol Injection Of Morton's Neuroma Ismentioning

confidence: 99%

Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)—part VI, foot and ankle

et al. 2021

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Objectives Clarity regarding accuracy and effectiveness for interventional procedures around the foot and ankle is lacking. Consequently, a board of 53 members of the Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) reviewed the published literature to evaluate the evidence on image-guided musculoskeletal interventional procedures around this anatomical region. Methods We report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who reviewed the published literature for evidence on image-guided interventional procedures offered around foot and ankle in order to derive their clinical indications. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus was considered strong when > 95% of experts agreed with the statement or broad when > 80% but < 95% agreed. The results of the Delphi-based consensus were used to write the paper that was shared with all panel members for final approval. Results A list of 16 evidence-based statements on clinical indications for image-guided musculoskeletal interventional procedures in the foot and ankle were drafted after a literature review. The highest level of evidence was reported for four statements, all receiving 100% agreement. Conclusion According to this consensus, image-guided interventions should not be considered a first-level approach for treating Achilles tendinopathy, while ultrasonography guidance is strongly recommended to improve the efficacy of interventional procedures for plantar fasciitis and Morton’s neuroma, particularly using platelet-rich plasma and corticosteroids, respectively. Key Points • The expert panel of the ESSR listed 16 evidence-based statements on clinical indications of image-guided musculoskeletal interventional procedures in the foot and ankle. • Strong consensus was obtained for all statements. • The highest level of evidence was reached by four statements concerning the effectiveness of US-guided injections of corticosteroid for Morton’s neuroma and PRP for plantar fasciitis.

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“…This technique is effective for Morton's neuromas, postsurgical and posttraumatic neuromas, and nerve ablation in idiopathic neuralgia. 30 US-guided cryoablation for peripheral neuromas, most commonly interdigital neuromas, is now well established. The same technique can also be performed for less common neuropathic pain sources, such as Joplin's neuromas, 31 stump neuromas in amputation, and for perineural scarring ( Fig.…”

Section: Ablationsmentioning

confidence: 99%

Interventional Imaging Techniques as Alternative to Surgery of the Foot and Ankle

Burke

Walter

Adler

2022

Semin Musculoskelet Radiol

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A variety of foot and ankle pathologies can impair patient's daily activities, ultimately requiring surgical management. However, with improvements in image-guided intervention, the joints, soft tissues, and osseous structures may be accessible using various percutaneous techniques as a potential alternative therapeutic tool, avoiding the need for surgery with its associated risks and morbidity. This article discusses the potential range of image-guided interventional treatments. Injections, aspiration, biopsies, cryoablation, and radiofrequency ablation are described. Newer novel treatments are also covered. Finally, the common pathologies of Morton's neuroma, Achilles tendinopathy, and plantar fasciitis are addressed.

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Sonographically Guided Cryoneurolysis

Cited by 46 publications

References 17 publications

The effectiveness of non‐surgical interventions for common plantar digital compressive neuropathy (Morton's neuroma): a systematic review and meta‐analysis

The effectiveness of non‐surgical interventions for common plantar digital compressive neuropathy (Morton's neuroma): a systematic review and meta‐analysis

Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)—part VI, foot and ankle

Interventional Imaging Techniques as Alternative to Surgery of the Foot and Ankle

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