The posterolateral fluoroscopy-guided injection technique into the posterior subtalar joint: description of the procedure and pilot study on patient outcomes

摘要

Objective To describe a posterolateral fluoroscopy-guided\udinjection technique into the posterior subtalar joint and to\udreport patient outcomes 1 month post-injection.\udMaterials and methods Twenty-three consecutive adult\udpatients who underwent fluoroscopy-guided injection into\udthe posterior subtalar joint using a direct posterolateral\udapproach and who returned an outcomes-based postal\udquestionnaire after receiving this injection were included.\udNumerical pain rating scale (NRS) data were collected prior\udto injection. NRS and Patient’s Global Impression of\udChange (PGIC) scales were completed 1 day, 1 week, and\ud1 month after injection. The proportion of patients who\udimproved was calculated for each time period. Baseline\udNRS data were compared to each time point using the\udWilcoxon test to assess differences. Spearman’s correlation\udcoefficient was used to compare the 20 min NRS score with\udall follow-up NRS scores. All available images were\udreviewed for the presence of subtalar osteoarthritis (OA).\udPatient charts were reviewed to identify characteristics of\udpatients referred for subtalar injections. Risk ratios were\udcalculated comparing presence of OA or other abnormalities\udwith improvement.\udResults A posterolateral approach for fluoroscopy-guided\udinjections into the subtalar joint is described. There was a\udsignificant reduction in the mean NRS score at all time\udperiods compared to baseline (p ≤ 0.004). One-third of\udpatients (7/21) reported clinically relevant improvement at\ud1 month.\udConclusions Fluoroscopy-guided puncture of the posterior\udsubtalar joint using a posterolateral approach is possible.\udClinically significant improvement is reported in 33% of\udpatients after 1 month.