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Risk factors and the associated cutoff values for failure of corticosteroid injection in treatment of Morton’s neuroma

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Abstract

Background

Understanding the risk factors that predict the prognosis of Morton’s neuroma after corticosteroid injection would help clinicians determine the appropriate treatment protocol. However, the cut-off values for the risk factors are unknown. The aim of this study was to identify the risk factors and cut-off values that predict failure of corticosteroid injection in treatment of Morton’s neuroma.

Method

Among 201 patients who had corticosteroid injection for Morton’s neuroma, 40 underwent further treatment after injections. Injection was performed with ultrasound guidance following ultrasound confirmation of the diagnosis. We compared demographic information, size of the neuroma, and other comorbidities between the patients who did and did not undergo further treatment after injection in order to determine the risk factors of failure. Receiver operating characteristic (ROC) curves were constructed to determine optimal cutoff values for each risk factor.

Results

Stepwise logistic regression analysis showed that larger neuromas (p < 0.001) and younger patients (p = 0.026) predicted the failure of corticosteroid injection. The optimal cutoff value for the size of the neuroma was 6.3 mm (sensitivity, 81%; specificity, 95%; positive predictive value, 84%; negative predictive value, 88%) for predicting the failure of corticosteroid injection. Age was not associated with a specific cutoff value.

Conclusions

This study found that, with a cut-off value of 6.3 mm, larger Morton’s neuromas were associated with failure of corticosteroid injection.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea

    Young Hwan Park, Ja Woon Lee & Hak Jun Kim

  2. Department of Orthopedic Surgery, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan, 15355, South Korea

    Gi Won Choi

Authors
  1. Young Hwan Park
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  2. Ja Woon Lee
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  3. Gi Won Choi
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  4. Hak Jun Kim
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Contributions

Young Hwan Park: Designed the study, Lead investigator and first author.

Ja Woon Lee: Study implementation, Data analysis and interpretation.

Gi Won Choi: Study implementation, Data analysis and interpretation.

Hak Jun Kim: Designed the study, Corresponding author, Primary surgeon, Approval of the final manuscript.

This study was approved by the institutional review board of our institution.

(KUGH17007).

This study was performed in two institutions (Korea University Guro & Ansan Hospital).

Corresponding author

Correspondence to Hak Jun Kim.

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Conflict of interest

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the contents of this study.

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Park, Y.H., Lee, J.W., Choi, G.W. et al. Risk factors and the associated cutoff values for failure of corticosteroid injection in treatment of Morton’s neuroma. International Orthopaedics (SICOT) 42, 323–329 (2018). https://doi.org/10.1007/s00264-017-3707-8

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  • DOI: https://doi.org/10.1007/s00264-017-3707-8

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