Abstract
In the present randomized prospective study, 2 different surgical techniques of endoscopic
plantar fascia release were compared. Of 547 patients with a diagnosis of plantar
fasciitis, 46 with no response to conservative treatment for ≥6 months were included.
Of the 46 patients, 5 were lost to follow-up. In group 1 (n = 21), plantar fascia
release was performed using a deep fascial approach (DFA), and in group 2 (n = 20),
the superficial fascial approach (SFA) with a slotted cannula technique was used.
Patients were evaluated using the American Orthopaedic Foot and Ankle Society Ankle
Hindfoot scale and visual analog scale at baseline and 3 weeks and 3, 6, and 12 months
after the initial surgery. At the final follow-up appointment, the Roles-Maudsley
score was used to determine patient satisfaction. At the final follow-up examination,
the mean American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale scores had
increased from 53.12 to 83.68, with a decrease in the mean visual analog scale score
from 7.95 to 1.65 noted. According to the Roles-Maudsley score, the success rate after
1 year was 90.47% for DFA group, 95% for the SFA group, and 92.68% for all patients.
Although no significant difference was found between the final functional scores,
better early postoperative scores were found in the SFA group. The mean duration of
the procedure was measured as 27.22 ± 9.41 minutes overall, 35 ± 5.62 minutes in the
DFA group, and 19.05 ± 4.01 minutes in the SFA group. Two early and two late complications
occurred in the DFA group with none reported in the SFA group. In conclusion, the
SFA is a faster and safer method of endoscopic plantar fascia release with better
early postoperative scores.
Level of Clinical Evidence
Keywords
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References
- Risk factors for plantar fasciitis: a matched case-control study.J Bone Joint Surg Am. 2003; 85: 872-877
- Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors.Foot Ankle Int. 2004; 25: 303-310
- The incidence of plantar fasciitis in the United States military.J Bone Joint Surg Am. 2009; 91: 2867-2872
- Painful heel: report of 323 patients with 364 painful heels.Clin Orthop Relat Res. 1965; 39: 178-186
- The efficacy of oral nonsteroidal anti-inflammatory medication (NSAID) in the treatment of plantar fasciitis: a randomized, prospective, placebo-controlled study.Foot Ankle Int. 2007; 28: 20-22
- Randomized controlled trial of calcaneal taping, sham taping, and plantar fascia stretching for the short-term management of plantar heel pain.J Orthop Sports Phys Ther. 2006; 36: 364-371
- Steroid injection for heel pain: evidence of short-term effectiveness. A randomized controlled trial.Rheumatology (Oxford). 1999; 38: 974-977
- Treatment of proximal plantar fasciitis with ultrasound-guided steroid injection.Arch Phys Med Rehabil. 2000; 81: 1416-1421
- Treatment of plantar fasciitis by iontophoresis of 0.4% dexamethasone: a randomized, double-blind, placebo-controlled study.Am J Sports Med. 1997; 25: 312-316
- Complications of plantar fascia rupture associated with corticosteroid injection.Foot Ankle Int. 1998; 19: 91-97
- Use of platelet rich plasma to treat plantar fasciitis: design of a multi-centre randomized controlled trial.BMC Musculoskelet Disord. 2010; 11: 69
- The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis.Arch Orthop Trauma Surg. 2012; 132: 781-785
- Platelets rich plasma for treatment of chronic plantar fasciitis.Arch Orthop Trauma Surg. 2012; 132: 1065-1070
- Treatment of chronic plantar fasciitis with botulinum toxin A: an open case series with a 1 year follow up.Ann Rheum Dis. 2005; 64: 1659-1661
- Treatment of pain attributed to plantar fasciitis with botulinum toxin A: a short-term, randomized, placebo-controlled, double-blind study.Am J Phys Med Rehabil. 2005; 84: 649-654
- Ultrasonographic guided botulinum toxin type A for plantar fasciitis: an outcome-based investigation for treating pain and gait changes.J Rehabil Med. 2010; 42: 136-140
- Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial.Arch Intern Med. 2006; 166: 1305-1310
- Effectiveness of prefabricated and customized foot orthoses made from low-cost foam for noncomplicated plantar fasciitis: a randomized controlled trial.Arch Phys Med Rehabil. 2009; 90: 701-706
- Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis.Foot Ankle Int. 1999; 20: 214-221
- A prospective trial of night splinting in the treatment of recalcitrant plantar fasciitis: the ankle dorsiflexion Dynasplint.Orthopedics. 2002; 25: 1273-1275
- Efficacy of EZStep in the management of plantar fasciitis: a prospective, randomized study.Foot Ankle Spec. 2011; 4: 218-221
- Extracorporeal shock wave therapy for chronic painful heel syndrome: a prospective, double blind, randomized trial assessing the efficacy of a new electromagnetic shock wave device.J Foot Ankle Surg. 2007; 46: 348-357
- Extracorporeal shock wave therapy for the treatment of plantar fasciitis.Foot Ankle Int. 2004; 25: 290-297
- Shockwave therapy for chronic proximal plantar fasciitis: a meta-analysis.Foot Ankle Int. 2002; 23: 301-308
- Plantar fasciitis: evaluation and treatment.J Am Acad Orthop Surg. 2008; 16: 338-346
- Endoscopic plantar fasciotomy for chronic heel pain.Foot Ankle Int. 2000; 21: 505-510
- A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome.J Foot Ankle Surg. 1995; 34: 305-311
- Outcomes of endoscopic versus open plantar fascia release: a clinical and radiological study.J Bone Joint Surg Br. 2012; 94: 34
- A review of 105 consecutive uniport endoscopic plantar fascial release procedures for the treatment of chronic plantar fasciitis.J Foot Ankle Surg. 2013; 52: 48-52
- Percutaneous plantar fasciotomy: a minimally invasive procedure for recalcitrant plantar fasciitis.J Foot Ankle Surg. 1998; 37: 269-272
- Endoscopic plantar fasciotomy for chronic plantar fasciitis/heel spur syndrome: surgical technique—early clinical results.J Foot Surg. 1991; 30: 568-570
- Indication, surgical technique and results of endoscopic fascial release in plantar fasciitis (EF RPF).Knee Surg Sports Traumatol Arthrosc. 2004; 12: 471-477
- Endoscopic surgery for plantar fasciitis: application of a deep-fascial approach.J Arthrosc Relat Surg. 2011; 27: 1105-1109
- Endoscopic debridement for treatment of chronic plantar fasciitis: an innovative technique and prospective study of 46 consecutive patients.J Foot Ankle Surg. 2016; 55: 748-752
- Clinical rating system for the ankle hindfoot, midfoot, hallux and lesser toes.Foot Ankle Int. 1994; 15: 7349-7353
- Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales.J Foot Ankle Surg. 2007; 46: 65-74
- Radial tunnel syndrome: resistant tennis elbow as a nerve entrapment.J Bone Joint Surg Br. 1972; 54: 499-508
- Conservative treatment of plantar heel pain: long term follow up.Foot Ankle Int. 1994; 15: 97-102
- Current therapeutic approaches for plantar fasciitis.Orthop Res Rev. 2014; 6: 33-34
- Results of endoscopic plantar fascia release.Foot Ankle Int. 2007; 28: 549-556
- Endoscopic plantar fasciotomy in the treatment of chronic heel pain.Can J Surg. 2008; 51: 281-283
- Functional outcome of endoscopic plantar fasciotomy.Foot Ankle Int. 2012; 33: 37-43
- Endoscopic plantar fascia release, calcaneal drilling and calcaneal spur removal for management of painful heel syndrome.Foot. 2010; 20: 121-125
- Endoscopic plantar fasciotomy: preliminary study with cadaveric specimens.J Foot Surg. 1991; 30: 170-172
- Plantar fasciitis: how successful is surgical intervention?.Foot Ankle Int. 1999; 20: 803-807
- Imaging study of the painful heel syndrome.Foot Ankle. 1987; 7: 345-349
- Operative treatment of subcalcaneal pain.Foot Ankle. 1989; 9: 317-323
- Prevalence of non-painful heel spur and its relation to postural foot position.J Am Podiatr Med Assoc. 1983; 73: 122-123
- Heel pain.Clin Orthop Relat Res. 1963; 28: 169-177
- Heel spur formation and the subcalcaneal enthesis of the plantar fascia.J Rheumatol. 2002; 9: 1957-1964
- Lateral column symptomatology following plantar fascial release: a prospective study.J Foot Ankle Surg. 2002; 41: 365-371
- An anatomic analysis of endoscopic plantar fascia release.Foot Ankle Int. 1995; 16: 552-558
- Resistant plantar fasciopathy: shock wave versus endoscopic plantar fascial release.Int Orthop. 2012; 36: 2147-2156
Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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