Comparison of the therapeutic outcomes between open plantar fascia release and percutaneous radiofrequency ablation in the treatment of intractable plantar fasciitis

Yusong Yuan,Yangbo Xu,Yuhui Kou,Hao Lu,Hailin Xu,Yuan Qian

doi:10.1186/s13018-020-1582-2

Abstract

BackgroundHeel pain is one of the most common complaints in foot and ankle clinic, and one of the leading causes of heel pain is plantar fasciitis.MethodsA retrospective analysis was carried out in 31 cases (39 feet) of patients with intractable plantar fasciitis. In the enrolled 26 cases, 16 patients (19 feet) received open plantar fascia release, and the other 15 patients (20 feet) received percutaneous radiofrequency ablation. The surgical results were assessed by visual analog scale (VAS) and American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AH) before and after surgery in all patients.ResultsAll 31 patients were followed up successfully, with a mean follow-up time of 58.77 months. There were no differences of patient’s demographics and characteristics information between the two groups. The average operative time of the feet in the open plantar fascia release is longer than that in the percutaneous radiofrequency ablation. Furthermore, the percutaneous radiofrequency ablation group had a shorter recovery time to normal activity than the open plantar fascia release group. There were no differences of postoperative VAS scores and the AOFAS-AH scores between the two groups. All patients reported satisfaction after either operation.ConclusionThe symptoms of pain and limb function were significantly improved in patients both of the partial plantar fascia release treated group and the percutaneous radiofrequency ablation treated group. The two types of surgical procedures shared the same long-term curative effects. However, percutaneous radiofrequency ablation was a better technique from the point of shorter operative time and postoperative recovery time.Trial registrationRetrospectively registered.

Highlights

Heel pain is one of the most common complaints in foot and ankle clinic, and one of the leading causes of heel pain is plantar fasciitis
Diagnosis of plantar fasciitis was made according to the guidelines described by McPoil et al for plantar fasciitis including tenderness in the plantar medial heel region on palpation, pain most noticeable with initial steps after a period of inactivity and worse following prolonged weight-bearing, and pain often precipitated by a recent increase in weightbearing activity [14, 15]
The average time that patients recovered to normal activity was 25.94 days in the plantar fascia open release group and 13.27 days in the percutaneous radiofrequency ablation group

Summary

Methods

A retrospective analysis was carried out in 31 cases (39 feet) of patients with intractable plantar fasciitis. Patients A retrospective analysis was carried out in intractable plantar fasciitis patients who received surgical treatment in the Department of Orthopedic Surgery of our hospital during March 2009 to July 2018. The patients who suffered intractable plantar aponeurositis still felt stubborn heel pain after 6 months of conservative treatment. The inclusion criteria were patients diagnosed with plantar fasciitis, patients with failure of conservative treatment for at least 6 months, and patients without flatfeet or gastrocnemius contracture. The exclusion criteria were patients with any previous history of surgery for heel pain, associated pathology involving the lower limb such as history of tarsal tunnel syndrome, effusion of the ankle indicating an intra-articular disease, Achilles tendinopathy, patients with systemic disorder like diabetes mellitus and rheumatoid arthritis, and any recent history of aspirin or aspirin-like drug intake

Results

Discussion

Conclusion