Treatment of plantar fasciitis through an endoscopic release: a retrospective long term follow-up

Abstract

Objective: The hind foot pain caused by plantar fasciitis is becoming more common. Due to the excellent results after conservative treatment, a small percentage of patients need surgical intervention. The objective of this study is to present the clinical results obtained in patients with plantar fasciitis submitted to endoscopic release. Methods: From 1991 to 2010, 22 patients (26 feet) were submitted to the treatment proposed for plantar fasciitis. All were treated conservatively without success for 14,8 months on average. Through two portals (one medial and one lateral) and fenestrated cannula with a blunt trochar was inserted from medial to lateral, dorsally to the plantar fascia, being exteriorized in the lateral portal. Under direct visualization, the medial two thirds of the fascia was released with a hook knife. Results: After an average follow-up of 9.6 years (2~19 years) we observed an improvement of AOFAS Score from 49 pre-op to 89 post-op. The only two patients (two feet – 8%) who had no improvements after treatment were submitted to a new procedure to treat new pathologies. Discussion: The plantar fasciitis should be treated conservatively and persistent cases need surgical treatment. To decrease the recovery period, minimally invasive methods have been developed to treat several pathologies. The technique proposed follows these new trends, proving to be safe and effective to treat plantar fasciitis. Conclusion: The endoscopic plantar fascia release proved to be a safe and effective procedure.