Abstract
Background:This systematic review aims to summarize the outcomes of gastrocnemius recession in the treatment of plantar fasciitis.Methods:A systematic review was performed according to PRISMA guidelines using the PubMed, Embase, Emcare, Web of Science, Scopus, and CINAHL databases. A 2-stage title/abstract and full text screening process was performed independently by 2 reviewers. Randomized controlled trials, cohort, and case-control studies reporting the results of gastrocnemius recession in patients with plantar fasciitis were included. The MINORS and Joanna Briggs Institute Criteria were used to assess study quality and risk of bias.Results:A total of 285 articles were identified, with 6 of these studies comprising 118 patients being ultimately included. Significant postoperative improvement in American Orthopaedic Foot & Ankle Society, visual analog scale, 36-Item Short Form Health Survey, Foot Forum Index, and Foot and Ankle Ability Measure scores were reported. Included studies also described an increase in ankle dorsiflexion range of motion and plantarflexion power. An overall pooled complication rate of 8.5% was seen, with persistent postoperative pain accounting for the most common reported complication. Gastrocnemius recession is associated with greater postoperative improvement than plantar fasciotomy and conservative stretching exercises.Conclusion:The current evidence demonstrates that gastrocnemius recession is effective in the management of plantar fasciitis, specifically in patients with gastrocnemius contracture who do not respond to conservative treatment.Level of Evidence:Level III, Systematic review of level I-III studies.
Highlights
IntroductionPlantar fasciitis refers to degeneration and inflammation of the proximal plantar fascia. The condition presents with plantarmedial heel pain, often exacerbated following periods of inactivity, such as upon waking in the morning. Approximately 1 million adults receive treatment for plantar fasciitis in the United States of America alone every year, with around 1/10th of all adults being affected at some point during their life.26,32A number of conservative treatment options are available, including nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, corticosteroid injections, and orthoses. Such conservative regimes provide symptom resolution within 12 months in approximately 90% of cases. Should symptoms persist following conservative measures, operative techniques such as plantar fasciotomy can be employed
Plantar fasciitis refers to degeneration and inflammation of the proximal plantar fascia.15,25 The condition presents with plantarmedial heel pain, often exacerbated following periods of inactivity, such as upon waking in the morning.15,21 Approximately 1 million adults receive treatment for plantar fasciitis in the United States of America alone every year, with around 1/10th of all adults being affected at some point during their life.26,32A number of conservative treatment options are available, including nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, corticosteroid injections, and orthoses.15,21,24 Such conservative regimes provide symptom resolution within 12 months in approximately 90% of cases.21,26,35 Should symptoms persist following conservative measures, operative techniques such as plantar fasciotomy can be employed
The current evidence demonstrates that gastrocnemius recession is effective in the management of plantar fasciitis, in patients with gastrocnemius contracture who do not respond to conservative treatment
Summary
Plantar fasciitis refers to degeneration and inflammation of the proximal plantar fascia. The condition presents with plantarmedial heel pain, often exacerbated following periods of inactivity, such as upon waking in the morning. Approximately 1 million adults receive treatment for plantar fasciitis in the United States of America alone every year, with around 1/10th of all adults being affected at some point during their life.26,32A number of conservative treatment options are available, including nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, corticosteroid injections, and orthoses. Such conservative regimes provide symptom resolution within 12 months in approximately 90% of cases. Should symptoms persist following conservative measures, operative techniques such as plantar fasciotomy can be employed.. A number of conservative treatment options are available, including nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, corticosteroid injections, and orthoses.. A number of conservative treatment options are available, including nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, corticosteroid injections, and orthoses.15,21,24 Such conservative regimes provide symptom resolution within 12 months in approximately 90% of cases.. This systematic review aims to summarize the outcomes of gastrocnemius recession in the treatment of plantar fasciitis. Randomized controlled trials, cohort, and case-control studies reporting the results of gastrocnemius recession in patients with plantar fasciitis were included. Gastrocnemius recession is associated with greater postoperative improvement than plantar fasciotomy and conservative stretching exercises. Conclusion: The current evidence demonstrates that gastrocnemius recession is effective in the management of plantar fasciitis, in patients with gastrocnemius contracture who do not respond to conservative treatment.
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