Efficacy of bone cement injection in the treatment of calcanodynia
Objective To analyze the filling rate of cement in calcaneus and investigate the effect of calcanodynia.Methods A total of 18 patients with calcanodynia in the Orthopedic Outpatient Clinic of Quanzhou First Hospital Affiliated to Fujian Medical University and Yueqing Hospital Affiliated to Wenzhou Medical University were selected from September 2019 to December 2022.All cases were treated conserva-tively for more than half a year without remission of symptoms.The local area was punctured and cement was injected.After the procedure,the calcaneus CT scan data were imported into Mimics 21.0 software,the cement injected into the calcaneus was separated and reconstructed,and the cement filling rate(IR)was calculated,and low filling group(1R％＜3.15％)and high filling group(IR％≥ 3.15％)were set up according to the median of IR.The visual analog score(VAS),AOFAS ankle-hind foot score and com-plications before surgery and 3 months after surgery were collected.Differences between the groups were analyzed using the independent sample t-test method.Then the Pearson correlation test was performed for IR,postoperative VAS,postoperative AOFAS,calcaneus volume,and cement diffusion volume.The effect of different filling rates of calcaneal cement on the efficacy of calcanodynia was analyzed.Results The VAS score was higher in the postoperative low filling group(3.33±1.00)than that in the high filling group(2.00±1.00);The AOFAS score in the postoperative low filling group(85.33±3.16)was lower than that in the high filling group(92.44±3.13).The differences were all statistically significant(t=2.83,4.80,P＜0.05);The preoperative VAS score(6.67±1.00)was higher than the postoperative VAS score(3.33±1.00),the preoperative VAS score in the high filling group(6.89±0.93)was higher than the postoperative VAS score(2.00±1.00);The low preoperative AOFAS score(62.67±2.74)was lower than the postoperative AOFAS score(85.33±3.16);The preoperative AOFAS score in the high filling group(61.33±3.16)was lower than the postoperative AOFAS score(92.44±3.13).The differences were all statistically significant(t=10.00,11.56,21.78,19.52,P＜0.01).The high filling group had better efficacy than the low filling group.Postoperative VAS score(2.89±1.00)and calcaneus volume(65.97±5.12)were negatively correlated with IR(2.86±1.08)(r=-0.524,-0.475,P＜0.05).The postoperative AOFAS score(87.93±3.15)and bone cement diffusion volume(2.03±0.39)were positively correlated with IR(2.86±1.08)(r=0.820,0.970,P＜0.05).All patients completed the op-eration successfully after the surgery,and there were no related complications such as puncture channel in-fection,neurovascular injury,and cement displacement,and only one patient with high filling rate had ce-ment leakage along the puncture channel.Conclusion The efficacy in the high cement filling rate group is better than in the low filling rate group,but the high cement filling rate may increase the risk of cement leakage.
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