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Endoscopic plantar fascia release via a suprafascial approach is effective for intractable plantar fasciitis

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To evaluate the medium-term clinical results of endoscopic plantar fascia release (EPFR) using a suprafascial approach for recalcitrant plantar fasciitis.

Methods

Twenty-four feet of twenty-three patients who underwent EPFR using a suprafascial approach were followed up for more than 2 years using the American Orthopedic Foot and Ankle Society (AOFAS) score. The AOFAS score at final follow-up was compared between patients who participated in athletic activity (group A) and those who were sedentary (group S) and between those with and those without calcaneal spur (group with CS and group without CS, respectively). The ability of patients to return to athletic activity, and if so, the time interval between surgery and return to athletic activity, were investigated in group A. Complications were recorded.

Results

The median follow-up duration was 48 months. The mean AOFAS score in all patients increased significantly between before surgery and final follow-up (P < 0.001). The mean score in group A at final follow-up was significantly higher than that in group S (P < 0.05). However, there was no significant difference in the mean score at final follow-up between the groups with and without CS. In group A, all patients could return to athletic activity after a median 8 weeks. Injury to the first branch of the lateral plantar nerve occurred in three feet.

Conclusion

EPFR using a suprafascial approach was effective for recalcitrant plantar fasciitis. However, the prognosis of sedentary patients was inferior to that of patients engaged in athletic activity.

Level of evidence

IV.

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References

  1. Ahmad J, Karim A, Daniel JN (2016) Relationship and classification of plantar heel spurs in patients with plantar fasciitis. Foot Ankle Int 37(9):994–1000

    Article  Google Scholar 

  2. Barrett SL, Day SV (1991) Endoscopic plantar fasciotomy for chronic plantar fasciitis/heel spur syndrome: surgical technique–early clinical results. J Foot Surg 30(6):568–570

    PubMed  CAS  Google Scholar 

  3. Blanco CE, Leon HO, Guthrie TB (2001) Endoscopic treatment of calcaneal spur syndrome: a comprehensive technique. Arthroscopy 17(5):517–522

    Article  CAS  Google Scholar 

  4. Brugh AM, Fallat LM, Savoy-Moore RT (2002) Lateral column symptomatology following plantar fascial release: a prospective study. J Foot Ankle Surg 41(6):365–371

    Article  Google Scholar 

  5. Davies MS, Weiss GA, Saxby TS (1999) Plantar fasciitis: how successful is surgical intervention? Foot Ankle Int 20(12):803–807

    Article  CAS  Google Scholar 

  6. DiGiovanni BF, Moore AM, Zlotnicki JP, Pinney SJ (2012) Preferred management of recalcitrant plantar fasciitis among orthopaedic foot and ankle surgeons. Foot Ankle Int 33(6):507–512

    Article  Google Scholar 

  7. Jerosch J, Schunck J, Liebsch D, Filler T (2004) Indication, surgical technique and results of endoscopic fascial release in plantar fasciitis (E FRPF). Knee Surg Sports Traumatol Arthrosc 12(5):471–417

    Article  Google Scholar 

  8. Johal KS, Milner SA (2012) Plantar fasciitis and the calcaneal spur: Fact or fiction? Foot Ankle Surg 18(1):39–41

    Article  CAS  Google Scholar 

  9. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15(7):349–353

    Article  CAS  Google Scholar 

  10. Komatsu F, Takao M, Innami K, Miyamoto W, Matsushita T (2011) Endoscopic surgery for plantar fasciitis: application of a deep-fascial approach. Arthroscopy 27(8):1105–1109

    Article  Google Scholar 

  11. Kumai T, Benjamin M (2002) Heel spur formation and the subcalcaneal enthesis of the plantar fascia. J Rheumatol 29(9):195719–195764

    Google Scholar 

  12. Kuyucu E, Koçyiğit F, Erdil M (2015) The association of calcaneal spur length and clinical and functional parameters in plantar fasciitis. Int J Surg 21:28–31

    Article  Google Scholar 

  13. Lareau CR, Sawyer GA, Wang JH, DiGiovanni CW (2014) Plantar and medial heel pain: diagnosis and management. J Am Acad Orthop Surg 22(6):372–380

    Article  Google Scholar 

  14. MacInnes A, Roberts SC, Kimpton J, Pillai A (2016) Long-term outcome of open plantar fascia release. Foot Ankle Int 37(1):17–23

    Article  Google Scholar 

  15. Nery C, Raduan F, Mansur N, Baunfeld D, Del Buono A, Maffulli N (2013) Endoscopic approach for plantar fasciopathy: a long-term retrospective study. Int Orthop 37(6):1151–1156

    Article  Google Scholar 

  16. Neufeld SK, Cerrato R (2008) Plantar fasciitis: evaluation and treatment. J Am Acad Orthop Surg 16(6):338–346

    Article  Google Scholar 

  17. Ogilvie-Harris DJ, Lobo J (2000) Endoscopic plantar fascia release. Arthroscopy 16(3):290–298

    Article  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan

    Wataru Miyamoto, Youichi Yasui, Shinya Miki, Hirotaka Kawano & Masato Takao

Authors
  1. Wataru Miyamoto
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  2. Youichi Yasui
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  3. Shinya Miki
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  4. Hirotaka Kawano
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  5. Masato Takao
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Corresponding author

Correspondence to Wataru Miyamoto.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

This research was not funded.

Informed consent

Informed consent was obtained from all the patients included in the study.

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Miyamoto, W., Yasui, Y., Miki, S. et al. Endoscopic plantar fascia release via a suprafascial approach is effective for intractable plantar fasciitis. Knee Surg Sports Traumatol Arthrosc 26, 3124–3128 (2018). https://doi.org/10.1007/s00167-017-4762-9

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  • DOI: https://doi.org/10.1007/s00167-017-4762-9

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