Objective: Morton's neuroma presents a challenge in terms of pain management. This study aimed to evaluate the available evidence on the efficacy and safety of radiofrequency ablation for Morton's neuroma.
Design: PRISMA guidelines were followed. Prospective clinical trials, cohort studies, and case series were also included. Data analysis was performed using Review Manager 5.4. Meta-analysis applied fixed- or random-effects models depending on the heterogeneity. Sensitivity analyses were performed to assess the effects of temperature, radiofrequency cycles, and imaging guidance.
Results: Eight studies (n = 237) were included. Significant pain reduction was observed at the final follow-up (MD5.74, 95%CI 5.58, 5.90). At the final follow-up, 47.57% (95%CI 25.13%-70.00%) experienced complete pain relief, while 16.40% (95%CI 11.86%-20.94%) reported no benefit at final follow-up. Sensitivity analyses found higher temperature settings (≥85 °C) conferred greater relief on VAS (MD-6.97, 95%CI -6.75 to -7.18) compared to temperatures <85 °C (MD-3.94, 95%CI -3.68 to -4.19). Fewer radiofrequency cycles (≤3) also demonstrated significantly greater VAS improvement (MD-6.97, 95%CI -6.75 to -7.18) versus >3 cycles (MD-4.79, 95%CI -3.02 to -6.57). Complications were minimal (2.1%), and most resolved without significant interventions.
Conclusion: Radiofrequency ablation, particularly at specific temperatures and cycle thresholds, is effective and safe for the management of Morton's neuroma.
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