Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2019; 86(1):65-71 | DOI: 10.55095/achot2019/010

Short-Term Outcomes of Endoscopic Treatment of Inferior Calcar Calcanei in Patients with Plantar FasciitisOriginal papers

M. BÉREŠ^1,2, P. NEORAL^1,2, R. HOLIBKA¹, R. KALINA¹, J. GALLO^1,2,*, J. ZAPLETALOVÁ³

¹ Ortopedická klinika Fakultní nemocnice Olomouc

² Ortopedická klinika Lékařské fakulty Univerzity Palackého v Olomouci

³ Ústav lékařské biofyziky Lékařské fakulty Univerzity Palackého v Olomouci

PURPOSE OF THE STUDY:
The prospective study evaluates the short-term outcomes of endoscopic treatment of calcar calcanei in patients who underwent unsuccessfully more than 6 months of conservative therapy.

MATERIAL AND METHODS:
Our study included 34 patients with refractory plantar fasciitis, in whom endoscopic treatment of inferior calcar calcanei with partial plantar fasciotomy was performed in the period from 01. 01. 2009 to 31. 07. 2015. The assessed parameters were the following: level of function, pain relief and patient satisfaction on the FAAM (Foot and Ankle Ability Measure) score and VAS (Visual Analog Scale) score with the minimum follow-up of 1 year.

RESULTS:
A marked increase in the FAAM score from 39.2 preoperatively to 94.0 one year after the surgery and also a major pain relief on the VAS score from the initial 8 to the median 0 were observed. In total, 79.4% of patients were symptom-free one year after the surgery. The recurrence of calcar calcanei or ossification was seen on the radiograph taken one year after the surgery in 8 patients (23.5 %).

DISCUSSION:
In our opinion, the most important outcome of our study is the considerable reduction in pain postoperatively (the median VAS score declined from 8 to 0 one year after the surgery) and concurrently a notable increase in the FAAM score (from 39.2 preoperatively to 94.0 one year after the surgery). Similar results of endoscopic partial fasciotomy were achieved also by some other authors. Therefore, this method can be considered validated. It has also been proven that the correlation between the calcar calcanei recurrence, or a higher BMI and recurrence of symptoms postoperatively is insignificant.

CONCLUSIONS:
The endoscopic treatment of inferior calcar calcanei and plantar fasciotomy with denervation of fascial attachment is a fast, minimally invasive and safe method which brings very satisfactory results in the treatment of refractory plantar fasciitis. It is evidenced by subjective patient satisfaction, great function improvement, considerable pain relief after the surgery together with a minimum incidence of complications.

Keywords: hindfoot, plantar heel pain, plantar fasciitis, arthroscopic treatment, short-term results

Published: February 1, 2019  Show citation