Endoscopic Plantar Fascia Release

Hogan, Kathleen A.; Webb, Darby; Shereff, Michael J.

doi:10.1177/107110070402501206

Cited by 40 publications

(29 citation statements)

References 12 publications

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“…However, there are multiple articles about other forms of treatment, including endoscopic release, 4,14,19,20,21 plateletrich plasma injections, 13,22,32 botulinum toxin A injection, 11,24 percutaneous frequency coblation, 31,35 extracorporeal shock wave therapy, 23,26 and radiotherapy. 2,15 One has to ask the question, If there are so many different modalities described, do any of them actually work?…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcome of Open Plantar Fascia Release

MacInnes

Roberts

Kimpton³

et al. 2015

Foot Ankle Int.

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Background: Plantar fasciitis is thought to be a self-limiting condition best treated by conservative measures, but despite this many patients have a prolonged duration of symptoms and surgery may be indicated. Partial plantar fascial release is reported to have a short-term success rate of up to 80%, but anecdotally this was not thought to represent our local experience. Methods: An audit of long-term patient-reported outcomes following open partial plantar fascia release was performed. A total of 30 patients (33 feet) were identified over a 10-year period and case notes were reviewed. Patients were contacted by letter and invited to complete 2 validated patient-reported outcome score questionnaires (Visual Analog Scale-Foot and Ankle [VAS-FA] and Manchester Oxford Foot Questionnaire [MOXFQ]). Responses were received from 24 patients (26 feet). The average ages were 42.4 (range 24-61) for male and 46.2 (range 33-60) for female patients, with a female/male ratio of 2.7:1. The average duration of treatment prior to operative intervention was 3.1 years (range 1-5). Preoperatively, our cohort underwent a range of conservative measures. All patients were reviewed postoperatively, and average time from surgery to completion of questionnaires was 80 months (range 14-130). Results: The outcomes were worse in patients who had received preoperative steroid injections and this was found to be statistically significant. The mean MOXFQ score was 33.6 ± 3.9 (0-64). Mean VAS-FA score was 57.8 ± 4.9 (24-100). Conclusion: This study found a negative correlation between duration of follow-up and outcome, in both MOXFQ and VAS-FA, showing that patients continued to improve many years postoperatively. The authors also found worse outcomes with preoperative steroid injections, better outcomes in older patients, and a weak gender bias, suggesting results in men were better than those in women. A prolonged recovery period and generally poor outcomes leads the authors to suggest that open plantar fascia release is of questionable clinical value and that patients may improve in the natural course of the disease, in spite of surgery. Level of Evidence: Level III, comparative study.

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Section: Discussionmentioning

confidence: 99%

Long-Term Outcome of Open Plantar Fascia Release

MacInnes

Roberts

Kimpton³

et al. 2015

Foot Ankle Int.

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“…The treatment regimens, once systemic etiologies have been eliminated, vary widely and the use of nonsurgical [2,4,6,7,9,16,18,[40][41][42] and surgical procedures [3,14,15,22,33] has been reported. The recommendations for conservative care which is commonly used as the primary treatment approach include the prescription of orthotic devices [18], corticoid infiltrations [6], systemic or local administration of antiinflammatory medications [40], electrophysiological methods [8], ultrasound or laser applications [2,4], physical therapy [41], and also extracorporeal shock wave therapy (ESWT) [16].…”

Section: Introductionmentioning

confidence: 99%

“…Pes planus, pes cavus, overpronation, discrepancy in leg lengths, excessive lateral tibial torsion, excessive femoral anteversion, weakness in the gastrocnemius muscle, the soleus muscle and the intrinsic foot muscles, or a tightness of the Achilles tendon are known to be anatomic and functional risk factors [42]. The origin of the spurs appears to be repetitive trauma that produced microtears in the plantar fascia near its attachment and the attempted repair led to inflammation which is responsible for the release and the maintenance of the symptoms [7,21,42].The treatment regimens, once systemic etiologies have been eliminated, vary widely and the use of nonsurgical [2,4,6,7,9,16,18,[40][41][42] and surgical procedures [3,14,15,22,33] has been reported. The recommendations for conservative care which is commonly used as the primary treatment approach include the prescription of orthotic devices [18], corticoid infiltrations [6], systemic or local administration of antiinflammatory medications [40], electrophysiological methods [8], ultrasound or laser applications [2, 4], physical therapy [41], and also extracorporeal shock wave therapy (ESWT)…”

mentioning

confidence: 99%

Radiation Therapy for Painful Heel Spurs

et al. 2007

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“…[7][8][9][10][11][12][13][14][15][16][17] The technique has been modified to remove the plantar calcaneal spur 18 and plantar calcaneal bursa. 19 However, the deep abductor hallucis fascia cannot be released by the reported techniques of endoscopic plantar fascia release.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain

Lui¹

2016

Arthroscopy Techniques

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Entrapment of the first branch of the lateral plantar nerve is a commonly missed cause of recalcitrant plantar heel pain. The diagnosis is made on a clinical ground with maximal tenderness at the site of nerve entrapment. Treatment of the nerve entrapment is similar to that for plantar fasciitis, with rest, activity modification, nonsteroidal antiinflammatory drugs, stretching exercise, and local steroid injection. Surgical release of the deep abductor hallucis fascia is indicated when conservative treatment failed. Endoscopic release of the nerve through the dorsal and plantar portals, as well as endoscopic plantar aponeurosis release, is a feasible approach. P lantar heel pain is one of the most common problems faced by orthopaedic surgeons. Differential diagnoses include plantar fasciitis, entrapment of the first branch of the lateral plantar nerve, fat pad disorders, stress fracture of the calcaneal body, fatigue fracture of the medial calcaneal tuberosity, rupture of the plantar aponeurosis, tarsal tunnel syndrome, sciatica, painful piezogenic heel papules, glomus tumor of the heel pad, and bone and soft tissue tumor. 1The most common cause of plantar heel pain is plantar fasciitis, which is usually cured with conservative care. Entrapment of the first branch of the lateral plantar nerve, which can occur together with plantar fasciitis, is one of the most commonly overlooked causes of plantar heel pain. The nerve consists of sensory fibers for the calcaneal periosteum and the long plantar ligament as well as motor fibers for the quadratus plantae, flexor digitorum brevis, and abductor digiti quinti muscles.2 Nerve entrapment syndrome has previously been considered only in cases with intractable heel pain, but it may play a role in the early phases of painful heel syndrome. 3Diagnosis of the nerve entrapment is made on clinical grounds. Early morning pain is uncommon with isolated nerve entrapment. It tends to cause more pain at the end of the day or after prolonged activity. This may be related to the engorgement of a vessel accompanying the first branch of the lateral plantar nerve causing ischemia of the nerve rather than pure static compression of the nerve by the fascia. 4 The pathognomonic sign is maximal tenderness at the medial border of the plantar heel where the nerve entrapment occurs.1 The diagnosis can be confirmed by injection of lidocaine and bupivacaine into the region of the nerve, resulting in complete, albeit temporary, relief of the pain.

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Endoscopic Plantar Fascia Release

Cited by 40 publications

References 12 publications

Long-Term Outcome of Open Plantar Fascia Release

Long-Term Outcome of Open Plantar Fascia Release

Radiation Therapy for Painful Heel Spurs

Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain

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