Visualization of the Plantar Aponeurosis

Kani, Kimia Khalatbari; Porrino, Jack; Taljanovic, Mihra S.; Mulcahy, Hyojeong; Chew, Felix S.

doi:10.1016/j.pmrj.2016.10.016

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…Plantar fasciitis was diagnosed based on 3 inclusion criteria: (1) tenderness to palpation over the plantar fascia origin at the calcaneus, (2) pain that is worse with walking or weightbearing activities, and (3) ultrasound image showing abnormal thickening or swelling of the plantar fascia, defined as a thickness greater than 4.5 mm. 10 In addition, patients must have tried and failed at least 3 of the following 5 treatment options: oral steroid or NSAID, plantar fascia cortisone injection, physical therapy, foot orthotic, or immobilization with a night splint, boot, or cast. Exclusion criteria were (1) prior avulsion, trauma, or infection in the heel; (2) prior surgical treatment for plantar fasciitis; (3) concomitant Achilles tendinopathy; and (4) any radiographic findings suggestive of the presence of additional pathology in the ankle or hindfoot, such as tibiotalar joint osteoarthritis, calcaneal stress fracture, tarsal coalition, or Charcot joint disease.…”

Section: Methodsmentioning

confidence: 99%

“…Plantar fasciitis is the most common cause of heel pain in adults. 10 Treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), oral steroids, night splints, foot orthotic, physical therapy, ice massage, stretching, and cortisone injection. 4 Unfortunately, about 10% of patients do not obtain significant clinical improvement with these treatments.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Percutaneous Plantar Fasciotomy Using Microdebrider Coblation Wand

et al. 2019

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Background: Plantar fasciitis is the most common cause of heel pain in adults. Multiple conservative treatment plans exist; however, some cases do not obtain significant clinical improvement with conservative treatment and require further intervention. This retrospective case study evaluated the success rate of percutaneous plantar fasciotomy and confounding comorbidities that negatively affect outcomes. Methods: A series of 41 patients treated with percutaneous plantar fasciotomy using the Topaz EZ microdebrider coblation wand were invited to participate in this retrospective follow-up study, and 88% ( N = 36) participated. A limited chart review was completed and the patients answered a survey with the visual analog scale (VAS) for pain and the Foot and Ankle Ability Measure (FAAM) questionnaire. Average outcomes were calculated and 45 variables were analyzed to determine if they were statistically significant confounders. Patients had symptoms for an average of 3 years before the procedure and were contacted for follow-up at an average of 14 months after the procedure. Results: The average VAS for pain score was 1.3 ± 1.8 and the average FAAM score was 92 ± 15. Eighty-nine percent of patients had a successful outcome, defined as FAAM greater than 75. In addition, patients at 18 months postprocedure reported complete or near-complete resolution of symptoms with an FAAM score greater than 97. Concurrent foot pathologies (eg, tarsal tunnel syndrome), oral steroid treatment prior to the procedure, and immobilization with a boot prior to the procedure were statistically significant negative confounders ( P < .05). Being an athlete was a positive confounder ( P = .02). Conclusion: Percutaneous plantar fasciotomy using a microdebrider coblation was an effective treatment for plantar fasciitis, particularly without concurrent foot pathology, with a low risk of complications. Level of Evidence: Level IV, retrospective case series.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes of Percutaneous Plantar Fasciotomy Using Microdebrider Coblation Wand

et al. 2019

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“…In plantar fasciitis, there is a loss of fibrillar structure noted as a decrease in the echogenicity of the collagen fibers, increased thickness over 4.5 mm, and perifascial collections and/or calcifications within the fascia. 5 , 9 Johannsen et al 8 observed the plantar fascia of 11 patients under ultrasonography after endoscopic partial plantar fasciotomy. Eight of 11 patients were observed pre- and 1-year postprocedure, and average thickness decreased from 6.0 to 3.5 mm.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Imaging Outcomes of Plantar Fasciotomy Using Microdebrider Coblation Wand

Colberg

Kenneth-Nwosa

Vélez

et al. 2022

Foot & Ankle Orthopaedics

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Background: A plantar fasciotomy using a microdebrider coblation wand may be an effective treatment for treating chronic plantar fasciitis. The objective of this prospective study was to determine the success rate of performing a plantar fasciotomy using a microdebrider coblation wand to treat plantar fasciitis and determine utility of ultrasonographic imaging to evaluate for recovery after treatment. Methods: Patients with plantar fasciitis treated with a plantar fasciotomy using a microdebrider coblation wand were prospectively followed for 1 year. Outcome measures included numeric rating scale (NRS) for pain, Foot and Ankle Disability Index (FADI), the Foot and Ankle Ability Measure for activities of daily living (FAAMA) and for sports (FAAMS), and plantar fascia thickness evaluated with ultrasonographic imaging. Results: Forty patients were included. Average patient age was 53.4 ± 9.9 years. Average symptom duration prior to the procedure was 20 ± 26 months. Five patients dropped out of the study at various points, most due to the COVID quarantine. The mean preoperative NRS score was 4.7 and at 3 and 6 months postprocedure was ≤2. At 1 year, the outcomes were all improved compared to the preoperative status: NRS 0.7±1.3 ( P < .001), FADI 107±16 ( P < .001), FAAMA 95%±10% ( P < .001), FAAMS 84%±19% ( P < .001), and plantar fascia thickness 6.8 ± 1.2 mm ( P = .014). Furthermore, 86% of patients had clinically successful outcome in pain, defined as NRS score ≤ 2 (95% CI 0, 2), and 91% of patients had a clinically successful outcome in their function, defined as having an FAAMA score ≥75%. There were no complications at the operative site either during or after the procedure. Conclusion: In this study of 40 patients followed prospectively, we found percutaneous plantar fasciotomy using a microdebrider coblation wand to be an effective treatment for plantar fasciitis, with a low incidence of complications. Ultrasonographic imaging may help evaluate for interval healing. Level of Evidence: Level IV, prospective case series.

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Visualization of the Plantar Aponeurosis

Cited by 2 publications

References 13 publications

Clinical Outcomes of Percutaneous Plantar Fasciotomy Using Microdebrider Coblation Wand

Clinical Outcomes of Percutaneous Plantar Fasciotomy Using Microdebrider Coblation Wand

Clinical and Imaging Outcomes of Plantar Fasciotomy Using Microdebrider Coblation Wand

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