The results and safety of endoscopic plantar fascia release for treatment of chronic plantar fasciitis

Abstract

Background

A prospective study was conducted to evaluate the results of endoscopic plantar fascia release (EPFR) and its safety in treating patients with chronic plantar fasciitis.

Patients and methods

Thirty patients who had chronic plantar fasciitis for more than 6 months participated in this study from March 2015 to June 2018. Seventeen patients were females, and thirteen were males with an average age of 46 years (ranged between 35 and 52 years). All patients had a failed history of conservative treatment. They were treated with endoscopic plantar fascia release. If a heel spur existed, it was resected by an arthroscopic burr. Pain and functional limitations were evaluated with the American Orthopedic Foot and Ankle Society Scale (AOFAS) and Roles and Maudsley score.

Results

At the end of follow-up, the mean AOFAS scoring changed significantly from 67 points before surgery to 93 points (P < .0001) which was clinically significant. Sixteen (53.3%) patients had excellent results, 8 (26.6%) patients had good results, 4 (13.33%) patients had acceptable results, and 2 (6.66%) patients had poor results. Three cases complained of postoperative superficial infection at the medial portal. Two cases developed numbness and paraesthesia at the sole of the foot. Three patients had ongoing start-up pain that resolved within two months. The mean duration to full weight bearing after surgery was 40 days. All patients returned to full activities by a mean of 10 weeks.

Conclusion

Endoscopy offers the optimum solution for the resistant cases, but is not without complications. EPFR should be reserved only for severe cases after a trial period of conservative methods of treatment.