scholarly journals Clinical And Plantar Fascial Morphologic Changes After Proximal Medial Gastrocnemius Release Treatment of Recalcitrant Plantar Fasciitis

2021 ◽  
Vol 6 (3) ◽  
pp. 247301142110273
Author(s):  
Alberto Ginés-Cespedosa ◽  
Ignacio Wormull Ugarte ◽  
Jesus Ares-Vidal ◽  
Alberto Solano-Lopez ◽  
Daniel Bianco Adames ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Plantar Fasciitis ◽  
Short Form ◽  
Plantar Fascia ◽  
Primary Objective ◽  
Medial Gastrocnemius ◽  
Level Of Evidence ◽  
Sf 36 ◽  
Bone Edema ◽  
Qualitative Variables

Background: Magnetic resonance imaging (MRI) has been used as a diagnostic and prognostic instrument to evaluate the results of conservative treatment for plantar fasciitis. However, there are scarce data available relative to changes in the plantar fascia after operative treatment. The primary objective of this study is to evaluate the imaging changes in patients with recalcitrant plantar fasciitis treated operatively by means of proximal medial gastrocnemius release. Methods: Thirteen patients with recalcitrant plantar fasciitis were studied with MRI preoperatively and 1 year after operative treatment. Quantitative (plantar fascia thickness) and qualitative variables (hyperintensity in the plantar fascia, insertional calcaneus bone edema, a plantar fascia tear, and the presence of perifascial collections) were assessed by 2 musculoskeletal radiologists. Clinical results were also measured with American Orthopaedic Ankle & Society (AOFAS), visual analog scale (VAS) pain, and 36-Item Short Form Health Survey (SF-36) scales. Results: The mean plantar fascia thickness was 6.59 mm preoperatively and 6.37 mm postoperatively ( P = .972). No statistically significant differences were found in any of the qualitative variables on comparing the pre- and postoperative periods. Patients reported clinical improvements in pain VAS, AOFAS measurement, and the physical subdomains of the SF-36 scale. Conclusion: Quantitative and qualitative variables assessed for the plantar fascia on MRI did not show any significant change after medial gastrocnemius release despite clear clinical improvement. Level of Evidence: Level II, perspective cohort study.

Relationship of Plantar Fascia Thickness and Preoperative Pain, Function, and Quality of Life in Recalcitrant Plantar Fasciitis

2018 ◽  
Vol 39 (8) ◽  
pp. 930-934 ◽  
Author(s):  
Carlo Gamba ◽  
Aleix Sala-Pujals ◽  
Daniel Perez-Prieto ◽  
Jesus Ares-Vidal ◽  
Alberto Solano-Lopez ◽  
...  
Keyword(s):  
Plantar Fasciitis ◽  
Case Series ◽  
Plantar Fascia ◽  
Health Perception ◽  
Functional Score ◽  
Preoperative Pain ◽  
Level Of Evidence ◽  
Sf 36 ◽  
American Orthopaedic ◽  
Relationship Of

Background: The measurement of plantar fascia thickness has been advocated as a diagnostic and prognostic instrument in patients with plantar fasciitis, but there are no data relative to it in recalcitrant plantar fasciitis. The aim of the study is to evaluate the correlation between plantar fascia thickness and pain, functional score, and health perception in patients with this condition. Methods: Thirty-eight feet were studied with ultrasound and magnetic resonance imaging to measure plantar fascia thickness. The visual analogue scale (VAS), American Orthopaedic Foot & Ankle Society Hindfoot Score (AOFAS), and SF-36 were then recorded for each patient. The relationship between the fascia and these scores was analyzed to evaluate the correlation of thickness with pain, functional level, and health perception of patients. Results: In patients with recalcitrant plantar fasciitis, plantar fascia thickness did not correlate with pain (VAS), AOFAS, or any item of the SF-36. Conclusion: The thickness of the plantar fascia in patients with recalcitrant plantar fasciitis did not correlate with its clinical impact, and thus, we believe it should not be used in treatment planning. Level of Evidence: Level IV, case series.

Proximal Medial Gastrocnemius Release Versus Open Plantar Fasciotomy for the Surgical Treatment in Recalcitrant Plantar Fasciitis

2019 ◽  
Vol 41 (3) ◽  
pp. 267-274 ◽  
Author(s):  
Carlo Gamba ◽  
Paula Serrano-Chinchilla ◽  
Jesus Ares-Vidal ◽  
Alberto Solano-Lopez ◽  
Gemma Gonzalez-Lucena ◽  
...  
Keyword(s):  
Surgical Management ◽  
Plantar Fasciitis ◽  
Controlled Trial ◽  
Demographic Data ◽  
Medial Gastrocnemius ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Duration Of Symptoms ◽  
Sf 36 ◽  
Plantar Fasciotomy

Background: Plantar fasciitis is a common cause of foot pain. If conservative treatment fails, there is no consensus as to the best surgical management for recalcitrant plantar fasciitis (RPF). The aim of this study was to compare the results obtained from proximal medial gastrocnemius release (PMGR) with those obtained from open plantar fasciotomy (OPF) in terms of pain, satisfaction, health-related quality of life, and American Orthopaedic Foot & Ankle Society (AOFAS) score. Methods: This is a prospective randomized trial conducted between 2012 and 2016. Patients with RPF for at least 9 months were included. Diagnosis was clinically made. The exclusion criteria were neuropathic heel pain; a history of previous foot fracture, surgery, or deformity; rheumatoid arthritis; or the need for long-term analgesic administration. After ruling out other conditions with magnetic resonance or ultrasound imaging, patients were randomized to be operated on with OPF or PMGR independently of the Silfverskjold test. Follow-up was carried out for up to 1 year. The AOFAS, visual analog scale (VAS) for pain, SF-36, and Likert scale for satisfaction were used to evaluate the results obtained. The analysis was done with 21 patients in the OPF group and 15 in the PMGR group. The demographic data (age, sex, body mass index, duration of symptoms, and positivity to the Silfverskjold test) of the groups were comparable. Results: No differences were found in terms of the AOFAS ( P = .24), VAS ( P = .14), or any item of the SF-36. Satisfaction was very good in 85.8% of the PMGR group and 89.5% of the OPF group ( P = .27). Faster recovery was observed in the PMGR group. Conclusion: OPF and PMGR provided good results for patients with RPF. Neither was superior to the other relative to pain, AOFAS score, satisfaction, or the SF-36. We recommend PMGR as the first option in RPF surgical management in order to avoid potential biomechanical complications related to OPF. Level of Evidence: Level I, therapeutic randomized controlled trial.

Endoscopic Plantar Fasciotomy vs Open Radiofrequency Microtenotomy for Recalcitrant Plantar Fasciitis

2017 ◽  
Vol 39 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Weining Wang ◽  
Inderjeet Singh Rikhraj ◽  
Andrew Chia Chen Chou ◽  
Hwei Chi Chong ◽  
Kevin Oon Thien Koo
Keyword(s):  
Functional Outcomes ◽  
Plantar Fasciitis ◽  
Short Form ◽  
Statistical Significance ◽  
Medical Outcomes ◽  
Level Of Evidence ◽  
Sf 36 ◽  
The Social ◽  
American Orthopaedic ◽  
Plantar Fasciotomy

Background: Although usually self-limiting, around 10% of patients develop recalcitrant plantar fasciitis despite conservative treatment. In such cases, operative intervention can be offered. Traditionally, plantar fasciotomy has been the treatment of choice, but recently, there has been a push for more minimally invasive approaches. Radiofrequency microtenotomy has also been increasingly used as a treatment option. In this study, we compare the outcomes of endoscopic plantar fasciotomy and open radiofrequency microtenotomy. Methods: Patients treated in our institution with either procedure between 2007 and 2015 were included and interviewed at baseline and 3 months, 6 months, and 12 months postoperatively using the American Orthopaedic Foot & Ankle Society (AOFAS) and 36-item Medical Outcomes Short Form (SF-36) questionnaires. They were asked questions to evaluate their expectation and satisfaction postoperatively. Demographic and clinicopathological data were prospectively collected from clinical charts and electronic records. Results: There was no difference in either treatment arms preoperatively and an overall improvement in all functional outcomes postoperatively. However, patients who had endoscopic plantar fasciotomy fared better at 3 months compared to patients who underwent open microtenotomy with the visual analog score component of the AOFAS hindfoot score (HINDVAS) and the social functioning and role-functioning–emotional reaching statistical significance ( P = .027, P = .03, and P = .03, respectively). There was no difference in functional outcomes at 6 or 12 months postoperatively. Conclusion: Endoscopic plantar fasciotomy was associated with an earlier improvement in functional outcome in our study. However, both treatments had equivalent outcomes at 1-year follow-up, suggesting that either method is reasonable in the treatment of chronic plantar fasciitis. Level of Evidence: Level III, comparative study.

scholarly journals Three-Spike Insole Can Substitute the Total Contact Insole (TCI) in Refractory Plantar Fasciitis: Randomized Control Trial

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0044
Author(s):  
Dong Woo Shim
Keyword(s):  
Plantar Fasciitis ◽  
Short Form ◽  
Thermoplastic Polyurethane ◽  
Three Dimensional ◽  
Plantar Fascia ◽  
Assessment Tools ◽  
Aofas Score ◽  
Sf 36 ◽  
Significant Difference ◽  
Patient Reported

Category: Hindfoot Introduction/Purpose: Plantar fasciitis is one of the common foot complaints that is chronic and can induce dysfunction. Approximately 80% of patients improve with conservative management such as stretching exercise, ice bag massage, and splint. Refractory plantar fasciitis, unresponsive to conservative care for more than 6months, can be treated with insole, extracorporeal shockwave therapy, injection, and surgery etc. Total contact insole (TCI) is effective in reducing pain with just putting it in the shoes but quite expensive and time consuming for the custom production. Therefore, we produced alternative three-spike insole that can press about half of patient’s plantar fascia using 3-dimensional (D) printing and compared the clinical outcomes with it and TCI. Methods: A pragmatic, participant-blinded randomized trial was carried out from February 2019 to January 2020. Inclusion criteria was refractory plantar fasciitis and the duration of follow-up for each patient was 6 months. Three-dimensional printing used thermoplastic polyurethane (TPU) for the material of insole and the hardness was 58 +- 5 Shore-A. Twenty-eight patients were randomly allocated to use a three-spike insole or a TCI (Figure 1). The following assessment tools were used; visual analog scale for pain, American Orthopaedic Foot & Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), Karlsson- Peterson (KP) score, Medical Outcomes Study Short Form-36 (SF-36) for quality of life, and Foot Function Index (FFI). The groups were evaluated by a blinded assessor at baseline and after 6, 12, and 24 weeks. Results: The groups were homogenous for the majority of variables at baseline. Overall patient reported satisfaction showed improvement from mean 5.2 (range, 1 - 12) weeks of wearing and patient’s wearing time in a day was mean 2.4 (range, 0.5 - 3.0) hours. All the subscales except for sports in FAOS and mental component summary in SF-36 showed significant improvement from 6 weeks in both groups. There was no significant difference in all parameters between both groups at 6 weeks but AOFAS score, some of FAOS subscales, KP score, SF-36, and FFI showed significantly better outcome in three-spike insole group at 12 weeks. Those significant differences in outcome parameters tended to diminish at 24 weeks. Conclusion: We reaffirmed that insole is effective in plantar fasciitis and showed the three-spike insole restores function rapidly comparing to TCI. Three-spike design that supports not the whole longitudinal arch but about half of it was efficient enough. We can manufacture the three-spike insole for the popularization that can lower the price and producing time.

Association of Visual Appearance on Outcomes After Hallux Valgus Surgery

2021 ◽  
pp. 107110072110199
Author(s):  
Hakan Bahar ◽  
Kadir Ilker Yildiz
Keyword(s):  
Hallux Valgus ◽  
Short Form ◽  
Functional Improvement ◽  
Level Of Evidence ◽  
Visual Appearance ◽  
Chevron Osteotomy ◽  
Sf 36 ◽  
Functional Scores ◽  
Group 2 ◽  
Group 1

Background: In this study, our aim was to determine the effect of cosmetic improvement on patient satisfaction and functional scores in hallux valgus (HV) surgery. Methods: Preoperative foot photographs of 105 patients who had undergone chevron osteotomy for HV between 2016 and 2018 were taken. The patients were divided into 2 groups. Twenty-four months after surgery, the preoperative foot photographs were shown to patients in group 1 (n = 52) but not to patients in group 2 (n = 53). The groups were then compared using the visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS Hallux MTP-IP), and the 36-Item Short Form Health Survey (SF-36) scores. Both groups were evaluated radiologically with preoperative and postoperative hallux valgus angles and intermetatarsal angles. Results: There was no difference between the 2 groups in terms of radiologic parameters either pre- or postoperatively, or AOFAS Hallux MTP-IP scores postoperatively. However, for group 1, the VAS was lower (0.4±0.8 vs 1.8±1.6, P = .003) and both the SF-36 physical functioning (88.3±18.1 vs 79.1±23.2, P = .017) and SF-36 mental health scores were higher (78.8±19 vs 69.2±16.3, P = .022). Conclusion: Visualizing improvement in the cosmetic appearance of the foot appears associated with patients’ perception of subjective pain and functional improvement. We recommend that preoperative foot photographs be taken and recorded. Level of Evidence: Level III, case-control study.

scholarly journals NONOPERATIVE VERSUS OPERATIVE TREATMENT OF PATIENTS WITH DEGENERATIVE SPONDYLOLISTHESIS

2016 ◽  
Vol 15 (1) ◽  
pp. 33-35
Author(s):  
Jose Alfredo Corredor ◽  
Fernando Flores de Araújo ◽  
Rodrigo Góes de Mendonça ◽  
Noel Oizerovici Foni ◽  
Nelson Astur ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Short Form ◽  
Degenerative Spondylolisthesis ◽  
Functional Results ◽  
Good Health ◽  
Nonoperative Treatment ◽  
Function Score ◽  
Cross Sectional ◽  
Sf 36 ◽  
Functional Scores

ABSTRACT Objective: To evaluate clinical and functional results of patients with lumbar degenerative spondylolisthesis treated with operatively or nonoperatively. Methods: Patients with degenerative spondylolisthesis treated either nonoperatively or operatively from 2004 to 2014 were selected from databases and a cross-sectional evaluation was performed. Outcome measures included back and leg visual analogue scales (VAS), Fischgrund criteria, Short Form-36 (SF-36) function score, and the modified Oswestry Disability Index (ODI). Results: 43 patients were evaluated: 20 with nonoperative treatment and 23 with operative treatment. Baseline characteristics were similar without significant differences between groups. Mean follow-up time was 43 months (range 10 - 72) for the nonoperative group and 36 months (range 6-80) for the operative group. Significant statistical difference in favor of operative group were found in back VAS (mean 4 versus 8, p = 0.000), leg VAS (mean 3 versus 6, p = 0.0015), SF-36 function score (mean 77 versus 35, p = 0.000), and ODI (mean 17 versus 46, p = 0.000). On the basis of the Fischgrund criteria, only 10 % of patients reported excellent or good health post nonoperative treatment versus 83% for those treated operatively (p = 0.000). Conclusion: In this cross-sectional study, we observed that symptomatic patients with degenerative spondylolisthesis who underwent operative treatment have superior clinical and functional scores compared to those that underwent nonoperative treatment.

Effect of Gender, Toe Extension Position, and Plantar Fasciitis on Plantar Fascia Thickness

2018 ◽  
Vol 40 (4) ◽  
pp. 439-446 ◽  
Author(s):  
Michael J. Granado ◽  
Everett B. Lohman ◽  
Noha S. Daher ◽  
Keith E. Gordon
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Case Control ◽  
Joint Position ◽  
Maximal Extension ◽  
Level Of Evidence ◽  
Males And Females ◽  
Healthy Males

Background: Ultrasound is a widely used diagnostic tool for patients with plantar fasciitis. However, the lack of standardization during the measurement for plantar fascia thickness has made it challenging to understand the etiology of plantar fasciitis, as well as identify risk factors, such as gender. The purpose of this study was to investigate gender differences regarding plantar fascia thickness while controlling for metatarsophalangeal (MTP) joint position in the healthy and those with unilateral plantar fasciitis. Methods: Forty participants (20 with unilateral plantar fasciitis and 20 controls) with plantar fascia thickness (mean age, 44.8 ± 12.2 years) participated in this study. The majority were females (n = 26, 65%). Plantar fascia thickness was measured via ultrasound 3 times at 3 different MTP joint positions: (1) at rest, (2) at 30 degrees of extension, and (3) at maximal extension. Results: When comparing gender differences, the males in the plantar fasciitis group had a significantly thicker plantar fascia than the females ( P = .048, η2 = 2.35). However, no significant differences were observed between healthy males and females. The males with unilateral plantar fasciitis also had significantly thicker asymptomatic plantar fasciae collectively compared with controls ( P < .05), whereas females with unilateral plantar fasciitis had a similar but not significant change. Conclusion: It appears that healthy males and females have similar plantar fascia thickness. However, as plantar fasciitis develops, males tend to develop thicker plantar fasciae than their female counterparts, which could have future treatment implications. Level of Evidence: Level III, case-control comparative study.

scholarly journals Effectiveness of shockwave therapy in the treatment of plantar fasciitis

2020 ◽  
Vol 28 (1) ◽  
pp. 7-11
Author(s):  
Renan Gonçalves Leão ◽  
Marina Mayumi Azuma ◽  
Gustavo Henrique Carillo Ambrosio ◽  
Flavio Faloppa ◽  
Eduardo Shoiti Takimoto ◽  
...  
Keyword(s):  
Plantar Fasciitis ◽  
Case Series ◽  
Sao Paulo ◽  
São Paulo ◽  
Post Intervention ◽  
Level Of Evidence ◽  
Shockwave Therapy ◽  
Case Series Study ◽  
Sf 36

ABSTRACT Objective: To evaluate the effectiveness of single-dose focal shockwave therapy in plantar fasciitis treatment. Methods: a primary, prospective study of a series of cases, conducted in the city of São Paulo, Brazil, by the Department of Orthopedics and Traumatology of the Universidade Federal de São Paulo, in Hospital São Paulo. All outcomes were measured at the time of inclusion of the patient in the study and at the post-intervention moments as it follows: three, six and twelve weeks. The VAS, AOFAS and SF-36 scales were applied by teams other than those who performed the SWT. Results: Data from 56 patients were collected during 2017 and 2018. There was improvement of the parameter evaluated (p < 0.005 and 95%CI) in all the periods in which the patients were reevaluated (3, 6 and 12 weeks), progressive improvement were observed in the three outcomes evaluated. Conclusion: Shock wave therapy was effective for plantar fasciitis treatment according to the proposed protocol considering pain, function and quality of life. Level of Evidence Ic, Case-series Study.

scholarly journals Effect of Psychotropic Medications on Hammertoe Reconstruction Outcomes

2020 ◽  
Vol 5 (3) ◽  
pp. 247301142094413
Author(s):  
Samuel D. Maidman ◽  
Amalie E. Nash ◽  
Amanda Fantry ◽  
Shay Tenenbaum ◽  
Yahya Daoud ◽  
...  
Keyword(s):  
Short Form ◽  
Medication Use ◽  
Psychotropic Medications ◽  
Activity Level ◽  
Mood Stabilizers ◽  
Level Of Evidence ◽  
Sf 36 ◽  
Significant Difference ◽  
Patient Reported ◽  
Before And After

Background: Hammertoe deformities can seriously affect activity level and footwear. The use of prescription, mood-altering medications is very common, with some estimates as high as 25% of the population. Mood disorders, especially depression, negatively affect the results of medical and operative treatments. This study assessed the relationship of mood-altering medication use with the outcomes and complications of operative reconstruction of hammertoes. Methods: Data were prospectively collected from 116 patients who underwent hammertoe reconstruction, including demographic information, medical history, the use of mood-altering psychotropic medications (antidepressants, anxiolytics, hypnotics, and mood stabilizers), and postoperative complications. Preoperative patient-reported outcomes were measured using the visual analog scale (VAS) for pain and Short Form Health Survey (SF-36), which were repeated at 1-year follow-up. Results: A total of 36.2% of patients were taking psychotropic medications. Medication and nonmedication groups had similar pain VAS and SF-36 Physical Component Summary (PCS) scores before and after surgery. Compared with nonmedication patients, patients on psychotropic medications had significantly lower SF-36 Mental Component Summary (MCS) scores preoperatively ( P = .001) and postoperatively ( P = .006), but no significant difference in the change in MCS (ΔMCS) from preoperative to postoperative. Psychotropic medication use was associated with superficial wound infections ( P = .048), but not other complications. Conclusions: Patients taking psychotropic medications were equally likely to benefit from forefoot reconstruction as nonmedication patients. Preoperative and postoperative PCS and VAS were not significantly different between medication and nonmedication groups. Although the medication group had lower absolute MCS, they reported the same magnitude of improvement in MCS (ΔMCS) as the nonmedication group. Level of Evidence: Level II, prospective cohort study.

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