2019

DOI: 10.24129/j.rpt.3301.fs1712042

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Fascitis plantar recalcitrante: ¿fasciotomía parcial o liberación de gemelo medial? Resultados preliminares a 6 meses

Tulia Ferrer-Catasus²,

Paula Serrano-Chinchilla³

et al.

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“…Two authors responded providing the additional data requested [ 31 , 32 ]. One author confirmed that two papers [ 29 , 30 ] contained data from the same study population, the more recent publication providing a longer follow-up timepoint [ 30 ]. One author did not respond following a request for additional data [ 28 ].…”

Section: Resultsmentioning

confidence: 90%

“…No studies compared a surgical procedure to a sham procedure, and none compared surgery to a minimal care/waiting list/no treatment group. Three studies compared one type of surgery with another: endoscopic deep fascial approach fasciotomy (DFAF) compared to endoscopic superficial fascial approach fasciotomy (SFAF) [ 24 ]; lateral plantar nerve release with drilling compared to without drilling [ 28 ]; open plantar fasciotomy compared to proximal medial gastrocnemius release (PMGR) [ 29 , 30 ]. Five studies compared surgery with a non-surgical intervention: PMGR and stretching compared to stretching alone [ 25 ]; endoscopic plantar fasciotomy (EPF) compared to platelet rich plasma (PRP) injection [ 26 ]; EPF compared to ECSWT [ 27 ]; EPF with heel spur removal compared to corticosteroid injections [ 31 ]; and EPF compared to cryosurgery [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two studies [ 24 , 32 ] described how early and late adverse events were classified. Four studies did not report methods used for measuring and classifying the adverse events reported [ 25 , 26 , 29 , 30 ]. Two studies did not provide information regarding adverse events [ 27 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

“…All included studies assessed disability or function. Six studies used the American Orthopaedic Foot and Ankle Society Ankle Hindfoot Scale (AOFAS-AHS) [ 24 – 27 , 29 , 30 , 32 ], one study used the Foot Functional index (FFI) [ 31 ], and one the Modified Mayo scoring system for PF [ 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…Health related quality of life . Two studies reported measures of HRQoL (Short Form (36) Health Survey Questionnaire [SF-36]) [ 25 , 29 , 30 ]. Six studies did not report HRQoL outcomes [ 24 , 26 – 28 , 31 , 32 ].…”

Section: Resultsmentioning

confidence: 99%

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What is the evidence for efficacy, effectiveness and safety of surgical interventions for plantar fasciopathy? A systematic review

¹

,

²

,

³

et al. 2022

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Aims To systematically review randomised control trials (RCT’s) assessing the effectiveness and safety of surgical interventions in adults with plantar fasciopathy (PF). Materials and methods We searched MEDLINE, EMBASE, Web of Science, Google Scholar, the Cochrane Central Register of Controlled Trials, trial registries and references lists. RCT’s comparing surgical interventions with non-surgical or surgical comparisons in adults with PF were included. Primary outcomes were changes in first step pain severity/intensity, and incidence/nature of adverse events. Secondary outcomes included foot and ankle related disability/function, health related quality of life, cost effectiveness, changes in other reported measures of pain and medication use. Data were extracted at short-term (≤3 months post-intervention), medium-term (>3months—≤6 months post-intervention) or long-term (>6 months—≤2 years post-treatment). Certainty of evidence was evaluated using the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results From 3620 screened records, we included 8 studies comprising 345 patients. Substantial variation across trials precluded meta-analysis, hence a narrative synthesis was conducted. We judged all studies to have high risk of bias. For all outcome comparisons our GRADE judgement for the certainty of the evidence was very low. Three studies compared one type of surgery with another largely showing little to no difference in outcomes for pain, function or quality of life. Five studies compared surgery with non-surgical interventions—three providing very low certainty evidence that surgery may improve pain and function at long-term follow-up compared to non-surgical comparisons, whereas two studies provided no long-term between-group differences. Reporting of adverse events were inadequate, inconsistent or absent across all studies. Conclusion There is a paucity of high certainty evidence to support or refute the effectiveness and safety of surgical interventions in the management of PF. We make recommendations for improving the evidence base in this field.

“…Two authors responded providing the additional data requested [ 31 , 32 ]. One author confirmed that two papers [ 29 , 30 ] contained data from the same study population, the more recent publication providing a longer follow-up timepoint [ 30 ]. One author did not respond following a request for additional data [ 28 ].…”

Section: Resultsmentioning

confidence: 90%

“…No studies compared a surgical procedure to a sham procedure, and none compared surgery to a minimal care/waiting list/no treatment group. Three studies compared one type of surgery with another: endoscopic deep fascial approach fasciotomy (DFAF) compared to endoscopic superficial fascial approach fasciotomy (SFAF) [ 24 ]; lateral plantar nerve release with drilling compared to without drilling [ 28 ]; open plantar fasciotomy compared to proximal medial gastrocnemius release (PMGR) [ 29 , 30 ]. Five studies compared surgery with a non-surgical intervention: PMGR and stretching compared to stretching alone [ 25 ]; endoscopic plantar fasciotomy (EPF) compared to platelet rich plasma (PRP) injection [ 26 ]; EPF compared to ECSWT [ 27 ]; EPF with heel spur removal compared to corticosteroid injections [ 31 ]; and EPF compared to cryosurgery [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two studies [ 24 , 32 ] described how early and late adverse events were classified. Four studies did not report methods used for measuring and classifying the adverse events reported [ 25 , 26 , 29 , 30 ]. Two studies did not provide information regarding adverse events [ 27 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

“…All included studies assessed disability or function. Six studies used the American Orthopaedic Foot and Ankle Society Ankle Hindfoot Scale (AOFAS-AHS) [ 24 – 27 , 29 , 30 , 32 ], one study used the Foot Functional index (FFI) [ 31 ], and one the Modified Mayo scoring system for PF [ 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…Health related quality of life . Two studies reported measures of HRQoL (Short Form (36) Health Survey Questionnaire [SF-36]) [ 25 , 29 , 30 ]. Six studies did not report HRQoL outcomes [ 24 , 26 – 28 , 31 , 32 ].…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

What is the evidence for efficacy, effectiveness and safety of surgical interventions for plantar fasciopathy? A systematic review

¹

,

²

,

³

et al. 2022

View full text Add to dashboard Cite

Aims To systematically review randomised control trials (RCT’s) assessing the effectiveness and safety of surgical interventions in adults with plantar fasciopathy (PF). Materials and methods We searched MEDLINE, EMBASE, Web of Science, Google Scholar, the Cochrane Central Register of Controlled Trials, trial registries and references lists. RCT’s comparing surgical interventions with non-surgical or surgical comparisons in adults with PF were included. Primary outcomes were changes in first step pain severity/intensity, and incidence/nature of adverse events. Secondary outcomes included foot and ankle related disability/function, health related quality of life, cost effectiveness, changes in other reported measures of pain and medication use. Data were extracted at short-term (≤3 months post-intervention), medium-term (>3months—≤6 months post-intervention) or long-term (>6 months—≤2 years post-treatment). Certainty of evidence was evaluated using the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results From 3620 screened records, we included 8 studies comprising 345 patients. Substantial variation across trials precluded meta-analysis, hence a narrative synthesis was conducted. We judged all studies to have high risk of bias. For all outcome comparisons our GRADE judgement for the certainty of the evidence was very low. Three studies compared one type of surgery with another largely showing little to no difference in outcomes for pain, function or quality of life. Five studies compared surgery with non-surgical interventions—three providing very low certainty evidence that surgery may improve pain and function at long-term follow-up compared to non-surgical comparisons, whereas two studies provided no long-term between-group differences. Reporting of adverse events were inadequate, inconsistent or absent across all studies. Conclusion There is a paucity of high certainty evidence to support or refute the effectiveness and safety of surgical interventions in the management of PF. We make recommendations for improving the evidence base in this field.

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