Endoscopic Plantar Fascia Release versus Cryosurgery for the Treatment of Chronic Plantar Fasciitis: A Prospective Randomized Study

Background In a prospective randomized study, we compared two different surgical techniques used in plantar fasciitis surgery. Methods Forty-eight patients diagnosed as having plantar fasciitis and treated for at least 6 months with no response to conservative modalities were included in this study. The patients were randomly assigned to receive endoscopic plantar fascia release (EPFR) or cryosurgery (CS). Patients were evaluated using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS) as a primary outcome measurement at baseline and 3 weeks and 3, 6, and 12 months after surgery. At the final follow-up visit, the Roles-Maudsley score was used to determine patient satisfaction. Results Five patients did not complete the 1-year follow-up examination (one in the EPFR group and four in the CS group). Thus, the study group included 43 patients. Although both groups showed significant improvement at the final evaluation, the patients in the EPFR group had significantly better AOFAS-AHS scores at 3 months. The success rate (Roles-Maudsley scores of excellent and good) in the EPFR group at 12 months was 87% and in the CS group was 65%. Conclusions Both EPFR and CS were associated with statistically significant improvements at 1-year follow-up. At 3-month follow-up, EPFR was associated with better results and a higher patient satisfaction rate compared with CS.

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Iatrogenic Lateral Plantar Nerve Injury After Endoscopic Plantar Fascia Release: A Case Report

Journal of the American Podiatric Medical Association ◽

10.7547/19-188 ◽

2020 ◽

Vol 110 (6) ◽

Author(s):

Yen-Chun Chiu ◽

Shih-Chieh Yang ◽

Yu-Hwan Hsieh ◽

Yuan-Kun Tu ◽

Shyh-Ming Kuo ◽

...

Keyword(s):

Case Report ◽

Nerve Injury ◽

Endoscopic Surgery ◽

Plantar Fasciitis ◽

Surgical Intervention ◽

Plantar Fascia ◽

Slight Improvement ◽

Lateral Plantar Nerve ◽

Plantar Fascia Release

We present a 57-year-old female patient with iatrogenic lateral plantar nerve injury caused by endoscopic surgery for plantar fasciitis. Nerve grafting surgery was recommended, but the patient refused further surgical intervention because of personal reasons. After 1-year follow-up in outpatient clinics, she achieved only slight improvement in the lateral foot symptoms and still required oral analgesics for pain control. The purpose of this case report is to remind physicians of such a rare and serious complication that can occur after endoscopic surgery for plantar fasciitis. Good knowledge of anatomy and skilled surgical technique could decrease this type of complication.

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Endoscopic Plantar Fascia Release: A Case Series

Foot & Ankle International ◽

10.1177/107110070302400213 ◽

2003 ◽

Vol 24 (2) ◽

pp. 176-179 ◽

Cited By ~ 35

Author(s):

R.A. Boyle ◽

G.L. Slater

Keyword(s):

Plantar Fasciitis ◽

Case Series ◽

Plantar Fascia ◽

Subjective Assessment ◽

Heel Pain ◽

Walking Distance ◽

Reliable Procedure ◽

Plantar Fascia Release ◽

Partial Release

Plantar fasciitis is a common disabling condition that can be recalcitrant to treatment. Endoscopic Plantar Fascia Release (EPFR) has received greater attention in recent years as a viable, and possibly superior, alternative to established open procedures for the treatment of plantar fasciitis. In a series of 17 patients (17 feet) with follow-up over an average of 16 months, we report a two portal endoscopic technique of partial release of the plantar fascia, as a successful, safe and reliable procedure for the treatment of plantar fasciitis in the patient group selected. The surgical results of 17 EPFR's performed by the same surgeon were reviewed. All patients had preoperative symptoms of subcalcaneal heel pain for greater than 12 months, all having undergone nonsurgical measures for at least 12 months. Of 17 feet, all reported marked improvement of preoperative symptoms within two months. Patients' subjective assessment of the procedure was strongly supportive, 100% totally satisfied or satisfied with only minor restrictions. Postoperatively, 82.4% reported mild or no pain, and 100% had improvement in walking distance. Complications all resolved within two to six months; there were no re-operations and no infections.

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Impact of procedural multimedia instructions for pH BRAVO testing on patient comprehension: a prospective randomized study

Diseases of the Esophagus ◽

10.1093/dote/doz068 ◽

2019 ◽

Cited By ~ 2

Author(s):

M D Moore ◽

K D Gray ◽

S Panjwani ◽

B Finnerty ◽

T Ciecerega ◽

...

Keyword(s):

Patient Satisfaction ◽

Randomized Study ◽

Data Entry ◽

Prospective Randomized Study ◽

Control Group ◽

Patient Comprehension ◽

Significant Difference ◽

Comprehension Score ◽

Video Group

SUMMARY The positive impact on patient comprehension and improved procedural outcomes when multimedia is utilized to convey instructions preprocedurally has been previously shown for gastrointestinal procedures such as colonoscopy. However, in gastroesophageal reflux testing (GERD), we continue to utilize verbal and written instructions to establish this diagnosis when we use BRAVO pH testing. This is arguably a more complex procedure involving stopping medications, placement of a device, and maintaining an accurate diary for the duration of the testing. We hypothesize that by utilizing multimedia to relay complex textual information, patients will have improved comprehension of periprocedural instructions thereby improving data entry and satisfaction of expectations during the procedure. Prospective randomized study of 120 patients undergoing endoscopic placement of the BRAVO pH monitoring capsule for evaluation of GERD receive either written preoperative instructions (control) or written plus video instructions (video group). A composite comprehension score was calculated using procedure-specific parameters of data entry over the 48-hour monitoring period. Patient satisfaction was evaluated on the basis of a five-point Likert scale. Extent of patient satisfaction was defined by the fulfillment of patient expectations. Exclusion criteria included patients who did not have access to the video or did not complete follow-up. Seventy-eight patients completed all follow-up evaluations. The video group (n = 44) had a significantly higher mean comprehension score when compared to the control group (n = 34) (9.6 ± 1.4 vs. 7.4 ± 2.0, P = 0.01). Overall satisfaction with instructions was significantly higher in the intervention group (91% vs. 47%, p 0.01). We detected no significant difference in comprehension or satisfaction scores in subgroup analyses of the video group comparing patients <65 and ≥65 years of age and by education level. Compared to standard written instructions, video instructions improved patient comprehension based on data evaluation, and satisfaction. Therefore, clinicians should consider incorporation of multimedia instructions to enhance patient periprocedural expectations and understanding of reflux pH testing using the BRAVO procedure.

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A novel closed technique for ultrasound-guided plantar fascia release with a needle: review of 107 cases with a minimum follow-up of 24 months

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02302-y ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

A. Iborra ◽

M. Villanueva ◽

P. Sanz-Ruiz ◽

Antonio Martin ◽

Concepción Noriega

Keyword(s):

Plantar Fasciitis ◽

Plantar Fascia ◽

Rehabilitation Program ◽

Heel Pain ◽

Ultrasound Guided ◽

Lateral Column ◽

Guided Surgery ◽

Plantar Fasciotomy ◽

Plantar Fascia Release

Abstract Background This study aims to analyze the clinical outcome of a new ultrasound-guided surgery for partial plantar fasciotomy performed with a needle for treatment of plantar fasciitis. Methods We performed a retrospective review of 107 patients diagnosed with plantar fasciitis who underwent ultrasound-guided release of the plantar fascia. The series included 62 males (57.9%) and 45 females (42.1%) treated between April 2014 and February 2018, with a mean follow-up of 21.05 ± 10.96 months (7–66) and a minimum follow-up of 24 months. The mean age was 48.10 ± 10.27 years (27–72). Clinical assessments and ultrasound examination were carried out before treatment, after 1 week, and then after 1, 3, 12, and 24 months. The clinical assessment was based on a visual analog scale and the Foot and Ankle Disability Index. Results Heel pain improved in 92.5% (99) of patients, but not in 7.4% (8 patients). In the group of patients whose heel pain improved, 9 experienced overload on the lateral column and dorsum of the foot, which improved with the use of plantar orthoses and a rehabilitation program. We recorded no nerve complications (e.g., paresthesia), vascular injuries, or wound-related problems. Conclusion Ultrasound-guided partial plantar fasciotomy with a needle is safe, since structures are under direct visualization of the surgeon and the risk of damage is minimal. Stitches are not necessary, and recovery is fast. Consequently, costs are low, and the patient can return to work quickly. This technique may represent a valid option for treatment of plantar fasciitis.

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A Prospective Randomized Study of Endoscopic versus Conventional Harvesting of the Radial Artery

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0000000000000386 ◽

2017 ◽

Vol 12 (4) ◽

pp. 231-238 ◽

Cited By ~ 6

Author(s):

Bob B. Kiaii ◽

Stuart A. Swinamer ◽

Stephanie A. Fox ◽

Larry Stitt ◽

Mackenzie A. Quantz ◽

...

Keyword(s):

Patient Satisfaction ◽

Wound Infection ◽

Radial Artery ◽

Artery Bypass ◽

Randomized Study ◽

Open Group ◽

Prospective Randomized Study ◽

Harvesting Technique ◽

Endoscopic Group

Objective The aims of the study were to determine whether endoscopic harvesting of the radial artery (RA) reduces morbidity due to pain, infection, and disability with improvement in satisfaction and cosmesis compared to the conventional technique and (2) to compare the 6-month angiographic patency of the RA harvested conventionally and endoscopically. Methods In a prospective randomized study, 119 patients undergoing coronary artery bypass grafting using the RA were randomized to have RA harvested either conventionally (n = 59) or endoscopically (n = 60). Results Radial artery harvest time (open wound time) was significantly reduced in the endoscopic group (36.5 ± 9.4 vs 57.7 ± 9.4 minutes, P < 0.001). Only one patient developed wound infection (1.6%) in the endoscopic group compared with six patients (10.2%), P = 0.061, in the conventional group. Although this was not statistically significant, clinically this was relevant in terms of reduction in postoperative morbidity. Postoperative pain in the arm incision was significantly lower in the endoscopic group at postoperative day 2 ( P < 0.001) and at discharge ( P < 0.001) and similar to the conventional open group at 6 weeks’ follow-up ( P = 0.103). Overall patient satisfaction and cosmesis were significantly better in the endoscopic group at postoperative day 2 ( P < 0.001), at discharge ( P < 0.001), and at 6 weeks’ follow-up ( P < 0.001). There was no difference in the arm disability postoperatively ( P = 0.505) between the two groups. Six-month angiographic assessment of 23 patients (12 endoscopic and 11 open) revealed no difference in the patency rate (10/12 in endoscopic and 9/11 in open group). Conclusions Endoscopic RA harvesting reduced the incidence of postoperative wound infection and wound pain and improved patient satisfaction and cosmesis compared with conventional harvesting technique. There was no difference in the 6-month angiographic patency of the RA harvested conventionally and endoscopically.

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