Abstract
Plantar fasciitis is a common cause of heel pain. Recalcitrant plantar fasciitis can
be difficult to manage. Medial gastrocnemius recession is increasingly being used
to treat recalcitrant plantar fasciitis, with advocates describing fewer complications
and quicker recovery time than other surgical options. This systematic review aimed
to determine the effectiveness of gastrocnemius recession for the treatment of patients
with recalcitrant plantar fasciitis. Multiple databases were searched using Preferred
Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The level of
evidence of each study was assessed according to the American Academy of Orthopaedic
Surgeons Levels of Evidence. The level of bias for each study was assessed using the
National Institutes of Health (NIH) Study Quality Assessment Tools. Seven studies
were retrieved: 3 retrospective case series, 1 retrospective study that compared gastrocnemius
recession to open plantar fasciotomy, 1 prospective cohort study (pre-post study with
no control group), and 2 randomized controlled trials. All 6 studies that assessed
pre- and postoperative pain using the Visual Analogue Scale showed a large reduction
in pain postoperatively. Four studies that assessed pain at 12 months postoperatively
showed a weighted mean of 76.06 ± 10.65% reduction in pain. No major complications
were reported. Minor complications included sural neuritis. This review found a consistent
reduction in pain following gastrocnemius release in patients with recalcitrant plantar
fasciitis, suggesting it is a very promising treatment. However, the included studies
are limited by low quality study designs and inherent biases, limiting the strength
of recommendation. Further definitive, well-designed trials are required.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: November 01, 2021
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2021 by the American College of Foot and Ankle Surgeons. All rights reserved.
