Endoscopic Plantar Fascia Release

Abstract

Endoscopic release of the plantar fascia is becoming an increasingly popular alternative to open procedures for the treatment of chronic plantar fasciitis. Although most patients can be successfully treated with Achilles tendon stretching, orthoses, physical therapy and corticosteroid injections, a small percentage of patients will have symptoms that are refractory to such treatments. This is a retrospective review, analyzing the clinical outcome of 22 consecutive patients treated for chronic plantar fasciitis with endoscopic plantar fascia release by a single orthopaedic foot and ankle surgeon. These patients complained of symptoms for an average of 7.43 months before referral to the senior author (MS); 11 patients had chronic symptoms for 12 months or more. The ages at surgery ranged from 30 to 73 years. Followup averaged 8.48 (range 6 to 20) months. Satisfaction rate with this procedure was 97.7% and all patients reported at least a 50% improvement in pain after surgery. Twenty-two patients completed a modified Mayo Foot and Ankle Score: 15 of 22 (68%) were judged to have good or excellent results. Bilateral symptoms and prior ankle trauma or surgery were significantly correlated with less favorable results. Patients who had no previous foot trauma and had unilateral symptoms obtained the best results from this procedure. Even patients who had some residual pain in their foot were satisfied with the procedure and with the level of pain relief that had been achieved. Endoscopic plantar fascia release does appear to benefit selected patients who fail to respond to conservative therapy.