Abstract
Plantar fasciitis is one of the most common pathologies addressed by foot and ankle
surgeons. Despite advances and overall success rates for conservative therapy, many
of the recalcitrant cases proceed to require surgical correction. Partial to complete
release of the fascia is often performed altering foot biomechanics and severing the
windlass mechanism. Endoscopic debridement of the plantar fascia allows for direct
visualization and removal of the inflammatory tissue while leaving the fascia and
its function intact. A total of 125 feet were evaluated with a minimum follow-up time
of 5 years. Gender, body mass index, and duration of symptoms were all evaluated and
documented. Visual analog scale scores (VAS), American Orthopedic Foot and Ankle Score
(AOFAS), and Foot Function Index (FFI) were collected both pre- and postoperatively.
AOFAS, FFI, and VAS scores improved from a pre-operative mean of 57.6, 89.4%, and
8.6-89.1, 13.4%, and 0.7 respectively (p < .05) at final follow-up. Of the 125 patients, 98% stated they were satisfied with
the operative outcome and would undergo the procedure again. At final follow-up, no
patient suffered rupture of the fascia or recurrence. Patients were able to bear weight
immediately following the surgery in a walking boot and on average patients were able
to return to work at 3.4 days following surgery. This is a novel technique that does
not compromise the plantar fascia or alter foot biomechanics with promising 5-year
outcomes.
Level of Clinical Evidence
Keywords
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References
- In the clinic. Plantar fasciitis.Ann Intern Med. 2012; 156: 1-15
- Plantar fasciitis.Clin J Sport Med. 2004; 14: 305-309
- Treatment of plantar fasciitis.Am Fam Physician. 2001; 63 (477-8): 467-474
- Uniportal endoscopic plantar fasciotomy: a prospective study on athletic patients.Foot Ankle Int. 2004; 25: 882-889
- The instep plantar fasciotomy for chronic plantar fasciitis. A retrospective review.J Am Podiatr Med Assoc. 2000; 90: 66-69
- Plantar fascia: imaging diagnosis and guided treatment.Semin Musculoskelet Radiol. 2010; 14: 334-343
- Painful heel syndrome: results of nonoperative treatment.Foot Ankle Int. 1994; 15: 531-535
- Plantar fascia-specific stertching exercise improves outcomes in patients with chronic plantar fasciitis.J Bone Joint Surg. 2006; 88-A: 1775-1781
- Intense therapeutic ultrasound for treatment of chronic plantar fasciitis: a pivotal study exploring efficacy, safety, and patient tolerance.J Foot Ankle Surg. 2019; 58: 519-527
- Plantar fasciitis: evaluation and treatment.J Am Acad Orthop Surg. 2008; 16: 338-346
- The correlation between plantar fascia thickness and symptoms of plantar fasciitis.J Am Podiatr Med Assoc. 2011; 101: 385-389
- Plantar fasciotomy for intractable plantar fasciitis: clinical results and biomechanical evaluation.Foot Ankle. 1992; 13: 188-195
- Endoscopic plantar fasciotomy versus extracorporeal shock wave therapy for treatment of chronic plantar fasciitis.Arch Orthop Trauma Surg. 2010; 130: 1343-1347
- 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
- Extracorporeal shock wave therapy for the treatment of chronic plantar fasciitis: indications, protocol, intermediate results, and a comparison of results to fasciotomy.J Foot Ankle Surg. 2002; 41: 166-172
- Shock wave therapy for chronic proximal plantar fasciitis.Clin Orthop Relat Res. 2001; 387: 47-59
- Evaluation of long-term outcomes following plantar fasciotomy.Foot Ankle Int. 2018; 39: 1312-1319
- Endoscopic plantar fascia debridement for chronic plantar fasciitis.Clin Podiatr Med Surg. 2016; 33: 545-551
Article info
Publication history
Published online: November 09, 2022
Publication stage
In Press Corrected ProofFootnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
IRB: Due to the retrospective nature of the research, no risk was posed to the patients. All research was in accordance with the Declaration of Helsinki regarding research on human subjects.
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© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
