Endoscopic Plantar Fasciotomy Through Two Medial Portals for the Treatment of Recalcitrant Plantar Fasciopathy

Al-Ashhab, Mohamed Ebrahim Ali; El-Begawy, Hossam; Hasan, Hala Ali Abed

doi:10.1053/j.jfas.2017.09.004

Cited by 8 publications

(5 citation statements)

References 17 publications

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“…However, all these publications were follow‐up studies on cohorts and did not include control groups. In a randomized controlled trial comparing endoscopic plantar fasciotomy with extracorporeal shockwave therapy Radwan et al [29] found equal results for the two modalities after 36 months, while in a non‐randomized study with a control group of patients who had declined surgery Al‐Ashhab et al [1] found superior results for a deep operation with a medial approach as measured by the AOFAS score. As concluded by Mao et al in a systematic review [26] most studies demonstrate good outcomes, but the level of evidence is low and thus the grade of recommendations poor.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic fasciotomy for plantar fasciitis provides superior results when compared to a controlled non-operative treatment protocol: a randomized controlled trial

Johannsen

Konradsen

Herzog

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose Plantar fasciitis is a frequent and painful condition with a lifetime incidence of 10%. Good results have been reported for operative treatment of plantar fasciitis refractory to non-surgical interventions in uncontrolled studies. The aim of this study was to compare the results of operative treatment (endoscopic debridement, removal of the heel spur and partial resection of the plantar fascia) with those of a controlled and supervised non-operative rehabilitation program. Methods Thirty consecutive patients with plantar fasciitis during more than 3 months were randomized to either (1) nonoperative treatment with corticosteroid injections and a controlled strength training program or (2) an endoscopic 2-incision operation with partial fasciotomy and heel spur removal followed by the same strength training program. Patients were evaluated at entry and 3, 6, 12 and 24 months post-operatively with the foot function index (FFI) and pain score during activity on a 100 mm VAS scale (VAS activity). FFI at 6 and 12 months was defined a priori as primary endpoint. Results Both groups improved significantly over time. The FFI score was significantly better in the operated group compared to the non-surgically treated group 12 months post-operatively (p = 0.033), at 24 months this was, however, not significant (p = 0.06). VAS activity at 24 months was significantly (p = 0.001) in favor of the operative group. More patients returned to running and jumping in the operative group (p = 0.04). Conclusion This randomized controlled trial found significant and clinically relevant superior results for the operative treatment of plantar fasciitis as measured by Foot Function Index at 1 year and by VAS activity at 2-year follow-up when compared to the results of a supervised rehabilitation program. Level of evidence I.

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Section: Discussionmentioning

confidence: 99%

Endoscopic fasciotomy for plantar fasciitis provides superior results when compared to a controlled non-operative treatment protocol: a randomized controlled trial

Johannsen

Konradsen

Herzog

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…113 More recent studies recommend the use of early weight bearing as soon as the day of surgery, with the use of a walking boot, crutches, and walkers to protect the wound, and prevent falls. 82,86,114 A common theme across the recommendations listed in the literature are that physical therapy plays an important role in maintaining the operative gains and return of symptoms postoperatively. 82,86,113,114 For patients undergoing a gastrocnemius recession, the senior author's protocol calls for immediate weight bearing in a boot.…”

Section: Postoperative Managementmentioning

confidence: 99%

“…82,86,114 A common theme across the recommendations listed in the literature are that physical therapy plays an important role in maintaining the operative gains and return of symptoms postoperatively. 82,86,113,114 For patients undergoing a gastrocnemius recession, the senior author's protocol calls for immediate weight bearing in a boot. The goal of the boot is to maintain the tendon lengthening gained during the operation, and to protect the wound.…”

Section: Postoperative Managementmentioning

confidence: 99%

“…The rational presented was to protect the heel from scar formation, and to protect the calcaneus from fractures in the subset of patients who had bone spurs removed 113. More recent studies recommend the use of early weight bearing as soon as the day of surgery, with the use of a walking boot, crutches, and walkers to protect the wound, and prevent falls 82,86,114. A common theme across the recommendations listed in the literature are that physical therapy plays an important role in maintaining the operative gains and return of symptoms postoperatively 82,86,113,114…”

Section: Postoperative Managementmentioning

confidence: 99%

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Controversies in Surgical Treatment of Recalcitrant Plantar Fasciitis

Cheney

Sharpe

Lauf

et al. 2021

Techniques in Foot &Amp; Ankle Surgery

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Plantar fasciitis is a common cause of heel pain that is seen by both orthopedic surgeons and primary care providers. It is a condition that was previously thought to be because of inflammation of the plantar fascia but has more recently been linked an equinus contracture of the gastrocnemius muscle. The condition can be handled both conservatively and surgically, with the primary management being nonoperative. For operative interventions, the treatment of choice was classically a plantar fasciotomy. Over the past several years, the gastrocnemius recession has become an operative treatment of choice. The gastrocnemius recession has shown better symptom relief with less morbidity. The technique to perform a gastrocnemius recession is described within the chapter, as well as the postoperative management. In the future, the duration of nonoperative management for recalcitrant disease may be reduced. However, more randomized control trials showing positive results of the gastrocnemius recession may allow for shorter nonoperative management period creating a new standard treatment algorithm.

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“…The first level of treatment would include the use of non-steroidal anti-inflammatory drugs (NASAIDs), specific physical exercises (such as stretching of the plantar fascia), foot insoles, night splints, ice massage, and patient's instructions to lose weight, activity modifications, and not to use flat shoes or walk barefoot (Akınoğlu and Köse, 2018;Celik et al, 2016;Cinar et al, 2018;Huffer et al, 2017;Lim et al, 2016Lim et al, , 2016Montesano et al, 2020;Oliva et al, 2017;Palermi et al, 2020;Sirico et al, 2018). Other treatment options are local injections of corticosteroids (CSs) (Gurcay et al, 2017), anaesthetic, and botulinum toxin (Ahmad et al, 2017); extracorporeal shock wave therapy Hsu et al, 2018;Reilly et al, 2018); ultrasound scanning; radiofrequency ablation (Akınoğlu and Köse, 2018;Ozan et al, 2017); cryopreserved human amniotic membrane injections (Hanselman et al, 2015); prolotherapy (Kim and Lee, 2014;Ryan et al, 2009); ozone injections (Bahrami et al, 2019); hyaluronic acid injections (Kumai et al, 2018); platelet-rich plasma injections (PRP) (Chen et al, 2019;Franceschi et al, 2014;Singh et al, 2017;Sirico et al, 2017;Soraganvi et al, 2019); and surgical, such as endoscopic release (Al-Ashhab et al, 2018;Bernhard et al, 2018;Oliva et al, 2017). However, as yet, there is no consensus regarding the optimal treatment method , Eftekharsadat et al, 2016Kiter et al, 2006;Say et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided collagen injections for treatment of plantar fasciopathy in runners: A pilot study and case series

Corrado¹,

Bonini²,

Tarantino³

et al. 2020

Journal of Human Sport and Exercise - 2020 - Spring Conferences of Sports Science

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Background. Plantar fasciopathy is a frequent source of foot pain in athletes, and it is caused by the degeneration of the proximal insertion of the plantar fascia, usually triggered by repetitive microtrauma. Type I porcine collagen was shown to enhance tendon repair in vitro, and collagen injections are currently used to treat different tendinopathies. The aim of this study is to verify the effectiveness of collagen injections on pain and function in runners with plantar fasciopathy. Methods. Runners, who have been suffering from plantar fasciopathy for at least 6 months, were treated with a series of 4 ultrasound-guided type I porcine collagen injections, at weekly intervals. The Visual Analogue Scale, American Orthopedic Foot and Ankle Society-Ankle Hindfoot score and pressure algometry were used to verify the effects of collagen injections at 1-month and 3-month follow-up. Results. Compared to baseline, minor (p ≥ .05) and major (p ≤ .001) improvements on pain and function were registered at 1-month and 3-month follow-up, respectively. Conclusion. This is the first study that evaluates the effectiveness of collagen injections in the treatment of plantar fasciopathy in runners. Despite the limitations of this study, the positive findings could represent the starting point for further clinical trials.

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Endoscopic Plantar Fasciotomy Through Two Medial Portals for the Treatment of Recalcitrant Plantar Fasciopathy

Cited by 8 publications

References 17 publications

Endoscopic fasciotomy for plantar fasciitis provides superior results when compared to a controlled non-operative treatment protocol: a randomized controlled trial

Endoscopic fasciotomy for plantar fasciitis provides superior results when compared to a controlled non-operative treatment protocol: a randomized controlled trial

Controversies in Surgical Treatment of Recalcitrant Plantar Fasciitis

Ultrasound-guided collagen injections for treatment of plantar fasciopathy in runners: A pilot study and case series

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