• 1

    Thomas JL, Christensen JC, Kravitz SR, et al.: The diagnosis and treatment of heel pain: a clinical practice guideline-revision 2010. J Foot Ankle Surg 49: S1, 2010.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Beeson P: Plantar fasciopathy: revisiting the risk factors. Foot Ankle Surg 20: 160, 2014.

  • 3

    Tomczak RL, Haverstock BD: A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome. J Foot Ankle Surg 34: 305, 1995.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Riddle DL, Schappert SM: Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot Ankle Int 25: 303, 2004.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Berbrayer D, Fredericson M: Update on evidence-based treatments for plantar fasciopathy. PM R 6: 159, 2014.

  • 6

    Hsiao MY, Hung CY, Chang KV, et al.: Comparative effectiveness of autologous blood-derived products, shock-wave therapy and corticosteroids for treatment of plantar fasciitis: a network meta-analysis. Rheumatology (Oxford) 54: 1735, 2015.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7

    Jarde O, Diebold P, Havet E, et al.: Degenerative lesions of the plantar fascia: surgical treatment by fasciectomy and excision of the heel spur. A report on 38 cases. Acta Orthop Belg 69: 267, 2003.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Malahias MA, Cantiller EB, Kadu VV, et al.: The clinical outcome of endoscopic plantar fascia release: a current concept review. Foot Ankle Surg 26: 19, 2020.

  • 9

    Barrett SL, Day SV, Pignetti TT, et al.: Endoscopic plantar fasciotomy: a multi-surgeon prospective analysis of 652 cases. J Foot Ankle Surg 34: 400, 1995.

  • 10

    Benton-Weil W, Borrelli AH, Weil LS: Percutaneous plantar fasciotomy: a minimally invasive procedure for recalcitrant plantar fasciitis. J Foot Ankle Surg 37: 269, 1998.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Woelffer KE, Figura MA, Sandberg NS, et al.: Five-year follow-up results of instep plantar fasciotomy for chronic heel pain. J Foot Ankle Surg 39: 218, 2000.

  • 12

    Jerosch J, Schunck J, Liebsch D, et al.: Indication, surgical technique and results of endoscopic fascial release in plantar fasciitis (E FRPF). Knee Surg Sports Traumatol Arthrosc 12: 471, 2004.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13

    Lane GD, London B: Heel spur syndrome: a retrospective report on the percutaneous plantar transverse incisional approach. J Foot Ankle Surg 43: 389, 2004.

  • 14

    Komatsu F, Takao M, Innami K, et al.: Endoscopic surgery for plantar fasciitis: application of a deep-fascial approach. Arthroscopy 27: 1105, 2011.

  • 15

    Fallat LM, Cox JT, Chahal R, et al.: A retrospective comparison of percutaneous plantar fasciotomy and open plantar fasciotomy with heel spur resection. J Foot Ankle Surg 52: 288, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Ohuchi H, Ichikawa K, Shinga K, et al.: Ultrasound-assisted endoscopic partial plantar fascia release. Arthrosc Tech 2: e227, 2013.

  • 17

    Yanbin X, Haikun C, Xiaofeng J, et al.: Treatment of chronic plantar fasciitis with percutaneous latticed plantar fasciotomy. J Foot Ankle Surg 54: 856, 2015.

  • 18

    Cottom JM, Maker JM, Richardson P, et al.: Endoscopic debridement for treatment of chronic plantar fasciitis: an innovative technique and prospective study of 46 consecutive patients. J Foot Ankle Surg 55: 748, 2016.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Johannsen F, Konradsen L, Herzog R, et al.: Endoscopic fasciotomy for plantar fasciitis provides superior results when compared to a controlled non-operative treatment protocol: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 28: 3301, 2020.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Yin MC, Ye J, Yao M, et al.: Is extracorporeal shock wave therapy clinical efficacy for relief of chronic, recalcitrant plantar fasciitis? A systematic review and meta-analysis of randomized placebo or active-treatment controlled trials. Arch Phys Med Rehabil 95: 1585, 2014.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21

    Crawford F, Atkins D, Young P, et al.: Steroid injection for heel pain: evidence of short-term effectiveness. A randomized controlled trial. Rheumatology (Oxford) 38: 974, 1999.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22

    McMillan AM, Landorf KB, Gilheany MF, et al.: Ultrasound guided corticosteroid injection for plantar fasciitis: randomised controlled trial. BMJ 344: e3260, 2012.

  • 23

    Elizondo-Rodriguez J, Araujo-Lopez Y, Moreno-Gonzalez JA, et al.: A comparison of botulinum toxin a and intralesional steroids for the treatment of plantar fasciitis: a randomized, double-blinded study. Foot Ankle Int 34: 8, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Chiew SK, Ramasamy TS, Amini F: Effectiveness and relevant factors of platelet-rich plasma treatment in managing plantar fasciitis: a systematic review. J Res Med Sci 21: 38, 2016.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Malahias MA, Mavrogenis AF, Nikolaou VS, et al.: Similar effect of ultrasound-guided platelet-rich plasma versus platelet-poor plasma injections for chronic plantar fasciitis. Foot (Edinb) 38: 30, 2019.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26

    Li Z, Xia C, Yu A, et al.: Ultrasound- versus palpation-guided injection of corticosteroid for plantar fasciitis: a meta-analysis. PLoS One 9: e92671, 2014.

  • 27

    Debrule MB: Ultrasound-guided Weil percutaneous plantar fasciotomy. JAPMA 100: 146, 2010.

  • 28

    Jensen MP, Chen C, Brugger AM: Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain 4: 407, 2003.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Nikolaou VS, Malahias MA, Kaseta MK, et al.: Comparative clinical study of ultrasound-guided A1 pulley release. World J Orthop 8: 163, 2017.

  • 30

    Jacobson JA, Kim SM, Brigido MK: Ultrasound-guided percutaneous tenotomy. Semin Musculoskelet Radiol 20: 414, 2016.

  • 31

    Krey D, Borchers J, McCamey K: Tendon needling for treatment of tendinopathy: a systematic review. Phys Sportsmed 43: 80, 2015.

  • 32

    Markison RE: Percutaneous ultrasound-guided MANOS carpal tunnel release technique. Hand (N Y) 8: 445, 2013.

  • 33

    Hocaoglu S, Vurdem UE, Cebicci MA, et al.: Comparative effectiveness of radial extracorporeal shockwave therapy and ultrasound-guided local corticosteroid injection treatment for plantar fasciitis. JAPMA 107: 192, 2017.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34

    Kalaci A, Cakici H, Hapa O, et al.: Treatment of plantar fasciitis using four different local injection modalities: a randomized prospective clinical trial. JAPMA 99: 108, 2009.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35

    Acosta-Olivo C, Elizondo-Rodriguez J, Lopez-Cavazos R, et al.: Plantar fasciitis—a comparison of treatment with intralesional steroids versus platelet-rich plasma. JAPMA 107: 490, 2017.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36

    Karimzadeh A, Raeissadat SA, Erfani Fam S, et al.: Autologous whole blood versus corticosteroid local injection in treatment of plantar fasciitis: a randomized, controlled multicenter clinical trial. Clin Rheumatol 36: 661, 2017.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37

    Celik D, Kuş G, Sırma S: Joint mobilization and stretching exercise vs steroid injection in the treatment of plantar fasciitis: a randomized controlled study. Foot Ankle Int 37: 150, 2016.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38

    Ward ED, Smith KM, Cocheba JR, et al.: 2003 William J. Stickel Gold Award. In vivo forces in the plantar fascia during the stance phase of gait: sequential release of the plantar fascia. JAPMA 93: 429, 2003.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39

    Vohra PK, Japour CJ: Ultrasound-guided plantar fascia release technique: a retrospective study of 46 feet. JAPMA 99: 183, 2009.

Ultrasound-Guided Partial Plantar Fascia Release with the Use of a Fine Cutting Device for the Treatment of Persistent Plantar Fasciitis: A Case Series

View More View Less
  • 1 Stavros Niarchos Foundation, Hospital for Special Surgery, Complex Joint Reconstruction Center, New York, NY.
  • | 2 Second Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Konstantopouleio General Hospital, Athens, Greece.
  • | 3 Department of Trauma and Orthopaedics, Basingstoke and North Hampshire Hospital, Basingstoke, Hampshire, United Kingdom.
  • | 4 Department of Orthopaedic Surgery, McGill University, Jewish General Hospital, Montreal, Quebec, Canada.
Restricted access

Background: Plantar fasciitis is a common cause of musculoskeletal discomfort. Minimally invasive interventions are preferred as second-line treatments following failure of conservative management. We report on a novel technique of ultrasound-guided percutaneous release of the medial third of the plantar fascia with the use of a fine cutting device for the treatment of persistent plantar fasciitis.

Methods: This is a retrospective case series of all patients treated with the technique between 2013 and 2015. Patients had failed conservative management for a minimum of 6 months. The procedure was performed in an outpatient setting under local anesthesia. Under continuous ultrasound guidance, release of the medial third of the plantar fascia from the calcaneus was performed using an ophthalmic V-Lance knife through a medial stab wound entry point.

Results: Fifteen patients (six men and nine women) with an average age of 54.7 years were included. The mean (standard deviation [SD]) visual analogue scale score for pain improved significantly, from 66.0 (SD, 18.8) preoperatively to each consecutive follow-up point: 29.3 (SD, 25.2) at 2 weeks, 30.0 (SD, 27.8) at 4 weeks, and 34.0 (SD, 26.1) at 12 weeks (P < .001). The mild increase in visual analogue scale score between 4 and 12 weeks was statistically significant (P = .018). Average duration of required analgesia was 5.5 days and average time required to return to usual activities was 5.7 days. Two patients suffered with refractory neuropathic pain over the lateral border of the foot without any obvious abnormality.

Conclusions: Ultrasound-guided percutaneous release with the use of a fine cutting device could be an alternative option for the treatment of persistent plantar fasciitis. The technique is not without complications, and a mild but statistically significant decline in pain levels from early to short term has been detected. Therefore, the long-term outcomes of this technique need to be investigated before we can advocate its routine use.

Corresponding author: Leonidas Roumeliotis, MD, FEBOT, Private Orthopaedic Practice, 25 Daskalogianni Street, 11471 Athens, Greece. (E-mail: leonidasroumeliotis@yahoo.gr)