Foot Arch Changes after Endoscopic Plantar Fascia Release for Recalcitrant Plantar Fasciitis
https://doi.org/10.5704/MOJ.2207.010
- Author:
Liew SK
1
;
Saw A
2
;
Chua YP
3
Author Information
1. Department of Orthopaedic Surgery, Universiti Putra Malaysia, Serdang, Malaysia
2. NOCERAL, Department of Orthopaedic Surgery, Universiti Malaya, Kuala Lumpur, Malaysia
3. Department of Orthopaedic, Sunway Medical Centre, Bandar Sunway, Malaysia
- Publication Type:Journal Article
- Keywords:
endoscopic plantar fascia release, foot arch, footprint, plantar fasciitis, radiological measurements
- From:Malaysian Orthopaedic Journal
2022;16(No.2):78-86
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Endoscopic plantar fascia release (EPFR) is a
minimally invasive surgical intervention for recalcitrant
plantar fasciitis. Its efficacy has been convincing but the in
vivo effect on medial longitudinal foot arch and footprint has
not been studied. Our objective is to evaluate the changes of
foot posture using radiographs and footprints following
endoscopic plantar fascia release in recalcitrant plantar
fasciitis.
Materials and methods: This prospective cohort involved
patients with recalcitrant plantar fasciitis who failed six
months of conservative treatment. Two-portal endoscopic
release of not more than 50% of plantar fascia width was
performed. Footprint and standard weight-bearing
anteroposterior and lateral radiographs of the foot were taken
pre-operatively and at 12 months post-surgery. Arch index,
normalised navicular height truncated, calcaneal inclination
angle, calcano-1st metatarsal angle, talonavicular coverage
angle and talus-2nd metatarsal angle were measured.
Results: Sixteen patients (18 feet) were reported. Patients’
follow-up ranged from 14 to 31 months after surgery
(mean±SD: 23.44±5.76). The increase of arch index,
calcano-1st metatarsal angle and reduction of calcaneal
inclination angle were found statistically significant
(p<0.05). Two normal arch patients progressed to
asymptomatic flat arch feet. Three complications were noted
between three to nine months post-surgery, one with medial
column and two with lateral column symptoms.
Conclusion: There is evidence of reduction in medial
longitudinal arch of the foot after EPFR. Although the
reduction remains asymptomatic, post-operative
complications related to changes in biomechanics of the foot
can occur between three to nine months. Patients should be
monitored at least for 12 months and longer for those who
are symptomatic.
- Full text:16.2022my1252.pdf
