Endoscopic Partial Plantar Fasciotomy for Plantar Fasciitis

NewsBot · Sep 5, 2023

ENDOSCOPIC PLANTAR FASCIA RELEASE IN CASES OF CHRONIC RESISTANT
PLANTAR FASCIOPATHY
Mohammed Ali, Mohammed Redwan, Hassan Noaman & Moustafa Ibrahim
Egyptian Journal of Orthopaedic Research "EJOR" Volume 4, Issue 1, July - 2023: pp: 1-9 www.ejor.sohag-univ.edu.eg

Purpose : The intention of this study was to evaluate the efficacy of endoscopic plantar fascia release in
the therapy of resistive plantar fasciopathy. Material and Methods: 30 individuals with plantar
fasciopathy who had been recalcitrant to at least two forms of conservative therapy for at least six months
were selected to participate in a prospective research.. Most of our patients had already been clinically
diagnosed. Results: At 6 months after operation, the average AOFAS total score was significantly
increased from 35 (8-62) up to 85.5 (range, 71-100), (P < 0.001). The median VAS score was
significantly dropped from 10 (interquartile range, 9.25-10) up to 0 (interquartile range, 0-2.75) (P <
0.0001). The percentage of patients who scored good or exceptional on the Roles and Maudsley scale had
dramatically risen after 4 weeks, rising from 73% to 93% (28/30). There were no serious adverse events.
Conclusion: Endoscopic plantar fascia release is an efficient medication for people with relentless
resistant plantar fasciopathy.
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NewsBot · Sep 27, 2023

Endoscopic Plantar Fasciotomy as an Effective and Reliable Treatment for Plantar Fasciitis: An Overview of the Literature
Maria Papathanasiou et al
J Am Podiatr Med Assoc. 2023 Jul-Aug;113(4):21-239

Plantar fasciitis is a common cause of heel pain. The aim of this study was to review the current literature and attempt to clarify whether endoscopic plantar fasciotomy (EPF) is an effective and reliable treatment for plantar fasciitis in comparison with other invasive or noninvasive treatments. We performed an electronic search of the medical literature in PubMed database using combinations of the following keywords: plantar fasciitis, endoscopic treatment, and plantar aponeurosis. Overall, we had shown that patients had better scores following EPF/endoscopic plantar fascia release. The clinical scores were improved postoperatively and most of the patients were satisfied. Furthermore, the clinical trials showed that time to return to work or to previous activities was shorter compared with other treatments. These studies suggest that EPF/endoscopic plantar fascia release is probably an effective treatment of chronic plantar fasciitis. EPF is an efficient, safe treatment with good early postoperative results in patients with recalcitrant plantar fasciitis. There is evidence that other methods are equivalently effective for EPF, and some authors support that they should be considered as a second-line treatment because of their minimal invasive character and very low risk of complications; thus, more research is required.
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NewsBot · Jan 12, 2024

Retrospective Evaluation of Ultrasound Guided Percutaneous Plantar Fasciotomy With and Without Platelet Rich Plasma
Alexander Turner, BS et al
November 30, 2023

Plantar fasciitis is one of the most common foot conditions presenting to a foot and ankle specialist. Surgical treatment outcomes following plantar fasciotomy vary but short-term studies have reported excellent early pain relief and significant improvements in symptoms. This study evaluates patient reported pain scores collected pre- and post-op for patients who underwent percutaneous ultrasonic microtenotomy (PUT) plantar fasciotomy with PRP injection vs without the use of PRP. We compared pain visual analog scale (VAS) scores, for patients treated surgically by Orthopedic Surgery department of foot and ankle faculty members between December 2007 and December 2022. A total of 30 patients were identified that met inclusion and exclusion criteria. Our results showed that there was a significant decrease in pain VAS scores from pre-op visit (at least 1 month prior to operation) to post-op visit (at least 1 month following operation) for both groups, with a paired t test (p value <.0001). However, patients who received PRP had a statistically significant decrease in pain level compared to the group who did not receive PRP. Statistical analysis completed with a 2-sample t test (p-value <.0325). Our results found the mean time between the initial pre-op visit and last post-op follow-up visit was 19 months. The mean for time following surgical intervention was 10 months. The findings of our study suggest that the dual use of PUT and PRP to treat plantar fasciitis, could potentially lead to an improvement in pain reduction and longevity of pain relief.
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NewsBot · Feb 20, 2024

Effects of plantar fascia release and the use of foot orthoses affect biomechanics of the medial longitudinal arch of the foot. A cadaveric study
Jacobo Rodríguez-Sanz et al
Am J Phys Med Rehabil. 2024 Jan 12

Objective: To evaluate the effect of minimally invasive ultrasound-guided fascial release and a foot orthoses with first metatarsal head cut-out on the biomechanics of the medial longitudinal arch of the foot in cadaveric specimens.

Design: A cross-sectional study was designed (20 body-donors). Anthropometric measurements of the foot, foot posture index and the windlass test and force were measured in different conditions: unloaded, loaded position, with foot orthoses, after a 25% plantar fascia release and after a 50% release.

Results: For the anthropometric measurements of the foot, differences were found in foot length (p = 0.009), arch height (p < 0.001) and midfoot width (p = 0.019) when comparing the unloaded vs foot orthoses condition. When foot orthoses were compared with 25% plantar fascial release, differences were found in foot length (p = 0.014) and arch height (p < 0.001). In the comparation with 50% plantar fascial release, differences were found in the arch height (p < 0.001). A significant interaction between foot orthoses condition and grades was found in the arch height during the windlass test (p = 0.021).

Conclusion: The results indicate that the presence of foot orthoses leads to a significant increase in arch height compared to other conditions. Furthermore, when plantar fascia release is performed, the arch does not exhibit any signs of collapse.
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NewsBot · Mar 4, 2024

Ultrasonic Fasciotomy for the Treatment of Chronic Plantar Fasciopathy: A Prospective Study
Kruse, Ryan C. MD; Volfson, Elena BA
Clinical Journal of Sport Medicine ():10.1097/JSM.0000000000001215, February 23, 2024. | DOI: 10.1097/JSM.0000000000001215

Objective:
To evaluate the long-term efficacy and safety of an ultrasonic fasciotomy for plantar fasciopathy.

Design:
Prospective observational study.

Setting:
Tertiary care academic medical center.

Participants:
Patients with chronic plantar fasciopathy refractory to standard, conservative treatments were included in this study.

Interventions:
Patients underwent ultrasonic fasciotomy of the plantar fascia.

Main Outcome Measures:
The primary outcome measures were change in visual analog scale at 12 and 52 weeks post-procedure compared with baseline as well as patients' self-reported satisfaction with the procedure.

Results:
Sixty-seven patients were included. There was a significant improvement in visual analog scale at all follow-up time points, with an average overall improvement of 5.87 (P < 0.0001). 94% of patients reported satisfaction with the outcomes of their procedure at 12 and 52 weeks. No procedural complications were seen.

Conclusions:
This study demonstrates that an ultrasonic fasciotomy is a safe and effective treatment option for chronic plantar fasciopathy, with continued symptom improvement and a high degree of patient satisfaction up to 52 weeks post-procedure.

Clinical Relevance:
These findings suggest that an ultrasonic fasciotomy should be considered for patients with chronic plantar fasciopathy refractory to conservative treatments.
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NewsBot · May 2, 2024

Clinical Study of a Four-Step Program for the Treatment of Plantar Fasciitis with Bone Spurs
Lu Jiang et al
Orthop Surg. 2024 May 1

Objective: The most common causes of plantar and heel pain are plantar fasciitis and calcaneal spurs, and they often co-exist. Surgery is a recognized treatment for refractory plantar fasciitis. However, few studies have proposed treatment options for patients with metatarsophalangeal fasciitis with bone spurs. Accordingly, this study's purpose was to propose a four-step surgical regimen, and to improve the surgical outcome of plantar fasciitis with osteophytes and to establish a procedure for surgical treatment.

Methods: Retrospective analysis of 45 patients suffering from plantar fasciitis with bone spurs from 2020 to 2023. All patients underwent a four-step procedure, including plantar fascia release, calcaneal spur grinding, inflammatory tissue removal, and calcaneal burr decompression. The imaging parameters and functional scores were recorded before and after the operation. The objective evaluation included the measurement of calcaneal spur length on radiographs. Clinical evaluation included the American Orthopaedic Foot and Ankle Society (AOFAS), the Visual Analog Scale (VAS), and the Foot and Ankle Outcome Scale (FAOS). Measurement data that conformed to normal distribution were expressed as (x2 ± s), and pre-and postoperative AOFAS, FAOS, and VAS scores were compared using repeated-measures ANOVA, and preoperative and postoperative spur lengths were compared using paired t-tests.

Results: The 45 patients were followed up for 3 to 30 months, (17.72 ± 8.53) months, at final follow-up, the patient's AOFAS score improved from preoperative (74.93 ± 5.56) to (94.78 ± 3.98), FAOS score increased from preoperative (76.42 ± 3.37) to (96.16 ± 2.74), the VAS score decreased from (3.18 ± 0.54) to (1.07 ± 1.20) (p < 0.05), the length of spur decreased from (0.72 ± 1.81) cm to (0.23 ± 1.19) cm, and there were significant differences before and after operation (p < 0.05).

Conclusion: The four-step surgical regimen is an appropriate and effective surgical procedure to treat plantar fasciitis with bone spurs.
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NewsBot · Oct 10, 2024

Comparative effectiveness of endoscopic plantar fasciotomy, needle knife therapy, and conventional painkillers in the treatment of plantar fasciitis: a real-world evidence study
Zhang Yingjie et al
J Orthop Surg Res. 2024 Oct 7;19(1):633

Plantar fascia (PF) is the commonest causes of foot pain in the adult population. Several surgical treatments are available to treat PF. This study was aimed to investigate the clinical efficacy of three different treatments for plantar fasciitis. It was conducted among 60 patients, divided equally into three treatment groups named Needle Knife Therapy, Endoscopic Plantar Fasciotomy, and Conventional Painkillers. Descriptive and analytical analysis were done by using SPSS 25 software. VAS and AOFAS scores were analyzed. The maximum (n = 31) participants were in 41-60 year age range group with normal BMI. These differences of mean VAS and AOFAS pain scores between different treatment groups were statistically significant (One-way ANOVA, p < 0.01). Both scores found lower in the Endoscopic Plantar Fasciotomy group. This study opens a new window of knowledge to achieve sustained pain relief and functional improvement. Moreover, the superiority of Endoscopic Plantar Fasciotomy in treating plantar fasciitis compared to Needle Knife Therapy and Conventional Painkillers was explored.
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NewsBot · Nov 18, 2024

MINIMALLY INVASIVE SURGICAL TREATMENTS VERSUS NON-SURGICAL TREATMENTS FOR PLANTAR FASCIOPATHY
S. Møller
The European Orthopaedic Research Society (EORS) 32nd Annual Meeting, Aalborg, Denmark, 18–20 September 2024.

Introduction
Plantar heel pain, or plantar fasciopathy (PF), is a common musculoskeletal complaint, affecting 39% of lower-extremity tendinopathies in general practice. Conservative management is recommended as the first-line treatment, yet many patients continue to experience symptoms even after ten years. There is a significant lack of high-quality evidence for the effectiveness of various treatments, highlighting the need for more research.

Minimally invasive surgical options, such as endoscopic plantar fascia release and radiofrequency microtenotomy, have shown promise in reducing pain and improving outcomes. This systematic review aims to evaluate the effectiveness of these minimally invasive surgical treatments compared to non-surgical options in managing PF.

Method
The systematic review, registered on PROSPERO (CRD42024490498) and adhering to PRISMA guidelines, searched databases including PubMed, Embase, Cochrane, and others for studies from January 1991 to May 2024. Keywords included plantar fasciitis, plantar fasciopathy, and heel pain. Limited to human trials, the search strategy was refined with an information specialist and found no protocol duplicates.

Result
The systematic review identified eight studies involving 495 patients (56.2% women, average age 46.5 years). The studies compared various treatments, including endoscopic plantar fascia release (EPF), mini-scalpel needle (MSN) treatment, ultrasound-guided pulsed radiofrequency (UG-PRF), and needle electrolysis (NE), to non-surgical interventions and corticosteroid injections (CSI). Primary outcomes focused on pain reduction, with some needle treatments showing superior results (between-group diffence). No severe adverse events were reported.

Conclusion
In conclusion, plantar fasciopathy (PF) remains a prevalent and challenging condition, that can be resistant to conservative treatments. This systematic review highlights the potential of minimally invasive surgical options, such as endoscopic plantar fascia release and needle treatments, in reducing pain and improving functional outcomes. Despite some needle treatments showing superior results, the overall lack of high-quality evidence underscores the need for further research to establish the most effective management strategies for PF.
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NewsBot · Dec 21, 2024

The Effect of Plantar Calcaneal Spur Excision on Plantar Fascia Surgery Outcomes
Steven R. Cooperman et al
Source

Plantar heel pain is a prevalent condition affecting 10% of the population, with plantar fasciitis being the most common cause. Plantar calcaneal spurs are frequently associated with plantar fasciitis, yet their role in the condition and surgical outcomes remains unclear. This study investigates the impact of plantar calcaneal spur excision on the outcomes of plantar fascia surgery, utilizing a radiofrequency microtenotomy and bone marrow aspiration technique. A retrospective review of 136 plantar fascia surgeries was conducted with 83 cases including plantar calcaneal spur excision. Demographic and operative factors were analyzed. Outcomes included time to weight-bearing in a boot and shoes, symptom resolution, and complications. Plantar calcaneal spur excision was associated with a statistically significant delay in symptom resolution (p = 0.006) and time to weight-bearing in shoes (p = 0.020). A statistically significant difference was observed regarding operative laterality, with right-sided surgeries demonstrating an increased time to symptom resolution (p = 0.007) and a higher retreatment rate (p = 0.017) compared to left-sided surgeries. There was no significant difference in complication rates or the need for retreatment between excision and non-excision groups. These findings highlight the need for careful consideration of plantar calcaneal spur excision in surgical planning for plantar fasciitis, with implications for patient education and management strategies.
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NewsBot · Jan 23, 2025

Nano-Arthroscopic Plantar Fascia Release Technique
Elizabeth Cho et al
Arthrosc Tech. 2024 Jul 25;13(11):103118.

Multiple open and endoscopic techniques have been described for recalcitrant cases of plantar fasciitis. Compared with open techniques, endoscopic plantar fasciotomy has been shown to be safe and effective with decreased postoperative pain and quicker recovery, as well as decreased risk of soft tissue and neurovascular injury, while retaining the ability to provide direct visualization of the plantar fascia to facilitate proper release. Single-portal endoscopic techniques may offer additional advantages including less portal site and postoperative pain, earlier return to activities, and cost-effectiveness and higher patient satisfaction when performed in the office setting. This Technical Note describes the authors' technique for nanoscopic plantar fasciotomy using a single-portal needle arthroscopy system, as well as advantages and limitations of this technique.
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NewsBot · Apr 4, 2025

Endoscopic Debridement, Ostectomy, Release, and Radiofrequency: A Fully Endoscopic Technique for Treating Recalcitrant Plantar Fasciitis
Walter-Soon-Yaw Wong et al
Arthrosc Tech. 2024 Aug 1;13(12):103150.

Plantar fasciitis (PF), a common cause of heel pain, primarily results from inflammation of the plantar fascia due to excessive strain. Its complex pathophysiology, influenced by various biomechanical factors, has led to the development of diverse surgical techniques. Most of these techniques, when used in isolation, have shown benefits in treating refractory PF. We propose the debridement, ostectomy, release, and radiofrequency procedure, a minimally invasive approach combining (1) debridement of the suprafascial plane, (2) ostectomy of the calcaneal spur, (3) partial release of the medial plantar fascia, and (4) direct radiofrequency microtenotomy of the plantar fascia. For patients with gastrocnemius muscle tightness, the procedure may also include a medial endoscopic gastrocnemius release. The described procedure addresses the multifaceted pathology of PF in a single intervention. This comprehensive approach aims to improve patient satisfaction and functional outcomes.
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NewsBot · May 22, 2025

Minimally invasive surgical treatments versus non-surgical treatments or placebo for plantar fasciopathy: A systematic review
Stefan Møller et al
Foot Ankle Surg. 2025 May 1:S1268-7731(25)00115-8

Background: Due to advances in minimally invasive surgical treatments (MIST), this systematic review with a narrative synthesis aimed to investigate the effectiveness of MIST in improving pain compared with non-surgical treatment or placebo in patients with plantar fasciopathy (PF).

Methods: We systematically searched relevant databases for peer-reviewed studies comparing MIST to non-surgical treatments or placebo.

Results: Eight studies were included. The results demonstrated statistically significant superiority in pain reduction for percutaneous needle treatments compared to non-surgical treatments or placebo in five studies. One study compared endoscopic plantar fascia release to exercise and corticosteroid injections and found a statistically significant superiority of endoscopic plantar fascia release.

Conclusions: This systematic review found promising effects of needle treatments to reduce pain among patients with PF. Endoscopic plantar fascia release was superior to the comparator in one of three studies. High risks of bias and methodological heterogeneity limit the strength of the available evidence.
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NewsBot · May 24, 2025

Minimally invasive surgical treatments versus non-surgical treatments or placebo for plantar fasciopathy: A systematic review
Stefan Møller et al
Foot and Ankle Surgery 1 May 2025

Background
Due to advances in minimally invasive surgical treatments (MIST), this systematic review with a narrative synthesis aimed to investigate the effectiveness of MIST in improving pain compared with non-surgical treatment or placebo in patients with plantar fasciopathy (PF).
Methods
We systematically searched relevant databases for peer-reviewed studies comparing MIST to non-surgical treatments or placebo.
Results
Eight studies were included. The results demonstrated statistically significant superiority in pain reduction for percutaneous needle treatments compared to non-surgical treatments or placebo in five studies. One study compared endoscopic plantar fascia release to exercise and corticosteroid injections and found a statistically significant superiority of endoscopic plantar fascia release.
Conclusions
This systematic review found promising effects of needle treatments to reduce pain among patients with PF. Endoscopic plantar fascia release was superior to the comparator in one of three studies. High risks of bias and methodological heterogeneity limit the strength of the available evidence.
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NewsBot · Jun 12, 2025

Minimally invasive ultrasound-guided percutaneous plantar fasciotomy on chronic plantar fasciitis: A retrospective analysis
Rodrigo Encinas et al
Foot Ankle Surg. 2025 May 15:S1268-7731(25)00122-5

Background: Plantar fasciitis is one of the most common causes of foot pain among the population. This study aimed to review outcomes in patients undergoing Minimally invasive surgery (MIS) ultrasound-guided percutaneous plantar fasciotomy for the treatment of chronic plantar fasciitis.

Methods: A multicenter retrospective chart review of patients undergoing MIS using the Tenex device from January 2020 to December 2022. The main data points collected were Patient-Reported Outcomes Measurement Information System (PROMIS), follow-up times, revision surgery, and complications.

Results: 56 patients underwent 60 surgeries. The average age and BMI were 48.6 years (19-80), and 33.2 kg/m2 (19.7-58.6). The average follow-up was 27 months (13.3-48.6). The average improvement in pain, physical function, and mobility PROMIS scores were 5.2 (P < 0.01), 3.6 (P = 0.01), and 3.1 (P = 0.01).

Conclusion: MIS ultrasound-guided plantar fasciotomy appears to be a reliable surgical treatment option for chronic plantar fasciitis with high patient satisfaction and safety profile.
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NewsBot · Jun 13, 2025

Does local steroid injection have a prognostic value for endoscopic plantar fascia release in chronic plantar fasciopathy?
Mohamed A. Mohamed, Mohammed S. Redwan, Hassan H. Noaman & Moustafa Elsayed
BMC Musculoskeletal Disorders 09 June 2025

Purpose
To determine if previous local steroid injection can alter the patient response to endoscopic plantar fascia release.

Methods
It is a prospective non-randomized comparative study of 100 adult patients, suffered from plantar fasciopathy for at least one year, and had reported either temporary or no response to two or more of conservative treatments, including local corticosteroid injection. Enrolled patients were non-randomly allocated by convenience sampling into two groups. The first 50 patients who reported improvement in response to local corticosteroid injection were allocated to Group (A) The first 50 patients who did not report any improvement after injection were allocated to group (B) Both groups underwent endoscopic plantar fascia release. Clinical evaluation was carried out using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle-Hindfoot Scale (AOFAS) and Patient self-assessment (Roles and Maudsley score) preoperatively and at 4, 8 weeks, 3, 6, 12, and 24 months postoperatively.

Results
Both groups showed a statistically significant improvement in VAS for heel pain, AOFAS score, and Roles and Maudsley score. Group A demonstrated significantly better VAS, AOFAS, and self-assessment scores than group B at different follow-up intervals. Furthermore, trajectory analysis showed faster pain relief and functional recovery was observed in group A compared to group B.

Conclusion
Patients who experienced temporary improvement after local corticosteroid injection had better clinical outcomes following endoscopic plantar fascia release.
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NewsBot · Jun 13, 2025

Endoscopic Treatment of Chronic Plantar Fasciitis with Plantar Heel Spur Pain: A Combined Suprafascial and Infrafascial Approach
Marut Arunakul et al
Source

Background:
To determine whether a combined endoscopic suprafascial and infrafascial approach with medial and lateral portals is a safe and effective technique for the endoscopic treatment of chronic plantar fasciitis with plantar heel spur pain.
Methods:
An interventional, prospective study was conducted. A total of 61 patients with plantar fasciitis with plantar heel spur pain underwent an endoscopic plantar fasciotomy with plantar heel spur resection, using a combined suprafascial and infrafascial approach between January 2018 and August 2022. Preoperative Foot and Ankle Ability Measure (FAAM), 36-Item Short Form Health Survey (SF-36), and visual analog scale (VAS) scores were measured. The measurements were repeated at 6 weeks, 3, 6, and 12 months postoperatively and at the final follow up. Preoperative and 1-year postoperative film parameters (Meary angle, calcaneal pitch angle, medial cuneiform–fifth metatarsal height) were compared.
Complications were recorded at each encounter.
Results:
The mean follow up time was 2.6 ± 1.1 years. At the 6-week postoperative visit, the mean change in FAAM-ADL, FAAM-Sport, SF-36 physical component summary, SF-36 mental component summary, and VAS were 26.0,19.0, 44.8, 61.2, and −5.8, respectively. These changes were statistically significant (P < .001). These findings were sustained and generally improved at all other follow-up points: 3, 6, and 12 months postoperatively and final follow-up. The average period until the recovery of activities of daily living and sport activities were 2.6 and 8.6 weeks, respectively. There were no significant differences between the pre- and 1-year postoperative radiographic values (P > .05). No cases resulted in medial arch collapse. Five cases (8%) had an injury to the first branch of lateral plantar nerve.
Conclusion:
Endoscopic plantar fascia release and plantar heel spur resection using a combined suprafascial and infrafascial approach resulted in the improvement of postoperative FAAM, SF-36, and VAS scores and involved a low incidence of postoperative complications.
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NewsBot · Jul 1, 2025

Ultrasound-guided percutaneous needle fasciotomy. Case series
Ana M. et al
Source

Introduction: Heel pain is a frequent reason for consultation in health clinics and a small percentage of them tend to become chronic, giving rise to complex conditions that require surgical treatment for resolution. One of these cases in plantar fasciitis or recalcitrant fasciosis.
Patients and methods: A series of cases of five patients with chronic plantar fasciitis in whom conservative treatment has failed are presented. All of them underwent an ultrasound-guided partial fasciotomy with a 14 G needle.
Results: After the intervention, a considerable reduction in pain was achieved, measured through a Visual Analog Scale (VAS), and in the thickness of the plantar fascia, quantified by ultrasound. A high satisfaction score on the Likert Scale was also achieved.
Conclusion: Ultrasound-guided percutaneous needle fasciotomy is an effective and simple technique for the treatment of recalcitrant fasciitis, allowing rapid functional recovery and with a low risk of associated complications.
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NewsBot · Jul 13, 2025

Minimally Invasive (Endoscopic) Plantar Fascia Release- Does it Improve
the Outcomes? Two Years Follow Up
Gil Genuth et al
Source

Plantar fasciitis (PF), affecting 10% of individuals during their lifetime, is a leading cause of heel pain. While conservative management
remains the primary treatment, endoscopic plantar fasciotomy (EPF) has emerged as a minimally invasive surgical option for refractory
cases. This study evaluates outcomes of EPF in 80 patients, performed by a single surgeon, with a two-year follow-up.
Eighty patients (25 males, 55 females; mean age: 54.8 years, BMI: 28.75) with chronic PF unresponsive to six months of conservative
therapy underwent two-portal EPF from January 2021 to December 2022. Data collected included Visual Analogue Scale (VAS) scores,
American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scores, patient satisfaction, time to return to sports, and complications at
12 and 24 months postoperatively.
AOFAS scores improved from 34.3 preoperatively to 86.9 at one year and 90.2 at two years (p < 0.05). VAS scores decreased from 7.9
preoperatively to 3.3 at one year and 1.7 at two years (p < 0.05). Most patients (87.5%) resumed sports within nine months. Satisfaction
was high (89%), though 8% reported persistent pain, and 6% experienced minor wound infections resolved with topical treatment.
EPF is a safe and effective option for chronic PF, yielding substantial pain and functional improvements. Persistent heel pain affected 8%
of patients, highlighting the need for individualized treatment strategies.
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NewsBot · Jul 25, 2025

Endoscopic plantar fascia release via dual medial deep fascia approach for refractory plantar fasciitis: an effective, safe, and rapid surgical approach
Jianing Yu, Jinxi An, Sen Wang, Wei Liu, Ziheng Bu, Junchao Huang, Peng Wang, Tao Zhu, Peng Wu & Min Zhu
International Orthopaedics

Objective

This study aims to evaluate the clinical efficacy of endoscopic plantar fascia release through the modified dual medial deep fascia approach for the treatment of refractory plantar fasciitis.
Methods

A retrospective study was conducted involving 34 patients with refractory plantar fasciitis treated by endoscopic plantar fascia release through the modified dual medial deep fascia approach. Among them, 25 patients had concurrent calcaneal spurs. All patients were followed for a minimum of 12 months. Functional outcomes were assessed using the Visual Analogue Scale (VAS) and the American Orthopaedic Foot and Ankle Society (AOFAS) score, while structural evaluations included the Medial Longitudinal Arch Angle (MLAA), navicular tuberosity height-to-foot length ratio (NH/FL), and the Arch Index (AI). Differences between patients with and without calcaneal spurs were also analyzed.
Results

All patients completed at least 12 months of follow-up, with primary wound healing in all cases. Two patients experienced transient plantar skin numbness and small toe abduction difficulty, which resolved within three months. The VAS score decreased significantly from 6.53 ± 1.19 preoperatively to 1.18 ± 0.76 postoperatively, and the AOFAS score improved from 52.41 ± 5.23 to 93.29 ± 3.91 (both P < 0.05), indicating statistical significance. However, changes in the MLAA, NH/FL and AI were not statistically significant. Apart from age differences (49.04 ± 4.41 vs. 34.56 ± 3.13), no significant differences in other scores were observed between the calcaneal spur group and the non-calcaneal spur group at the final follow-up. Moreover, compared to the methods reported in other studies, our study demonstrated a shorter operative time and superior pain and functional outcomes.
Conclusion

The dual medial deep fascia approach for endoscopic plantar fascia release is a safe, quick, effective, and minimally invasive technique that yields favourable clinical outcomes. It has certain advantages compared to other techniques. The presence of calcaneal spurs does not impact postoperative outcomes.
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NewsBot · Aug 6, 2025

Comparison of Short-Term efficacy between medial and lateral dual incision approach and medial dual incision approach for endoscopic spur resection combined with plantar fascia release in the treatment of heel pain syndrome
Xuehai Dong et al
BMC Surg. 2025 Aug 4;25(1):337.

Background: This study employed a retrospective analysis to compare the short-term efficacy of the medial and lateral dual incision approach versus the medial dual incision approach for endoscopic spur resection combined with plantar fascia release in the treatment of heel pain syndrome, aiming to provide orthopedic surgeons with a reference for surgical treatment of heel pain syndrome.

Methods: From December 2022 to December 2023, a total of 44 patients were included in the study, with 22 cases in the medial and lateral dual incision group and 22 cases in the medial dual incision group. Postoperative follow-up lasted for 12 months, during which the following information was recorded: operative time and postoperative hospital stay. Clinical outcomes were evaluated using the Visual Analog Scale (VAS) for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score, and the Maryland Foot Score. Changes in calcaneal spur were assessed using lateral X-rays of the calcaneus.

Results: There was no significant difference in postoperative VAS, AOFAS, or Maryland scores between the two surgical approaches (P > 0.05), and both showed significant improvement compared to preoperative scores (P < 0.05). However, the operative time in the medial dual incision group was significantly shorter than that in the medial and lateral dual incision group (P < 0.05).

Conclusion: Compared to the medial and lateral dual incision approach, the medial dual incision approach for endoscopic spur resection combined with plantar fascia release achieves similar short-term clinical outcomes and safety in the treatment of heel pain syndrome. However, considering the shorter operative time, the medial dual incision approach may be a better choice
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NewsBot · Oct 21, 2025

A Novel Indigenous Endoscopic-Assisted Surgery for Intractable Plantar Fasciitis: A Case Series
Rajesh Simon, Sunish Zachariah, Nizaj Nasimudeen, Dennis P. Jose, Ani Susan Abraham & Pratik Vishavadia
Indian Journal of Orthopaedics

Background

Plantar fasciitis is the most common cause of heel pain in adults, and while most cases respond to conservative treatment, a subset of patients require surgical intervention. Endoscopic plantar fascia release (EPFR) is preferred for its minimally invasive nature and favorable outcomes. However, the cost of disposable instrumentation presents a barrier in low-resource settings. This study aims to evaluate the clinical effectiveness and safety of endoscopic plantar fascia release using reusable, affordable, autoclavable instruments developed as a cost-conscious alternative to disposable kits.
Methods

This prospective case series included 24 patients with intractable plantar fasciitis who underwent EPFR using reusable instruments between April 2019 and March 2024. Patients were assessed preoperatively and at 12 months postoperatively using the AOFAS Hindfoot Score and the VAS for pain. Data were analyzed using paired t tests with significance set at p < 0.05.
Results

The mean preoperative AOFAS score improved from 59.2 ± 3.8 to 84.4 ± 6.0 postoperatively (p < .001), and the mean VAS score decreased from 8.1 ± 1.7 to 2.4 ± 0.5 (p < .001). Pain relief was reported by 91.7% of patients. No major complications were observed.
Conclusion

Endoscopic plantar fascia release using reusable instruments is a safe and effective surgical option, providing significant pain relief and functional improvement. The use of reusable instruments offers a practical and potentially more affordable alternative in resource-limited settings.
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NewsBot · Nov 3, 2025

Ultrasound-Guided Percutaneous Fasciotomy and Debridement for Chronic Plantar Fasciopathy: Six-Year Patient-Reported Outcomes from a Retrospective Case Series
Chris T Ha et al
Foot Ankle Int. 2025 Nov 3:10711007251372136.

Background: Ultrasound-guided percutaneous fasciotomy and debridement (USPFD) is a minimally invasive treatment for patients with plantar fasciopathy refractory to conservative management. Previous studies have shown clinical improvement with USPFD, but pain relief and patient satisfaction have not been demonstrated beyond 2 years.

Methods: This retrospective case series included patients who underwent USPFD at a quaternary academic medical center between April 2013 and January 2018, with refractory plantar fasciopathy and at least 4 years' follow-up. Patient outcomes were assessed through electronic surveys and telephone interviews. Primary outcome measures included mean changes in visual analog scale pain (VAS-Pain) scores and patient satisfaction via Likert scale. Secondary measures included VAS-Pain with the first 5 steps, VAS-Pain during daily weightbearing, and procedural complications.

Results: Seventy unique procedures were identified among 62 patients. Follow-up data were obtained from 51 of 62 patients (82%) who responded to surveys or phone calls. This corresponded to 58 of 70 procedures (83%) at a mean postprocedure follow-up of 6.6 ± 1.4 years. Patients had a mean duration of symptoms of 2.1 ± 3.0 years prior to the procedure. Baseline VAS-Pain was 6.8 ± 2.2 and final follow-up VAS-Pain was 0.7 ± 1.1. At the last follow-up, patient-reported VAS-Pain with first 5 steps was 0.9 ± 1.6 and VAS-Pain with weightbearing through the day was 1.3 ± 1.8. Overall, 91% (53/58) of the procedures were considered successful, where patients responded they were "satisfied" or "very satisfied" and 52 of 58 (90%) procedural responses indicated that based on the outcome, they would recommend the procedure to others. Final follow-up VAS-Pain, VAS-first 5 steps, and VAS-weightbearing, were all improved in the success vs failure groups (P ≤ .002). No complications were reported.

Conclusion: USPFD was associated with high patient satisfaction and durable pain relief for chronic plantar fasciopathy at an average follow-up of 6.6 ± 1.4 years.
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NewsBot · Dec 7, 2025

Minimally invasive ultrasound-guided percutaneous plantar fasciotomy on chronic plantar fasciitis: A retrospective analysis
Rodrigo Encinas et al
Foot and Ankle Surgery Volume 31, Issue 8, December 2025, Pages 737-741

Background
Plantar fasciitis is one of the most common causes of foot pain among the population. This study aimed to review outcomes in patients undergoing Minimally invasive surgery (MIS) ultrasound-guided percutaneous plantar fasciotomy for the treatment of chronic plantar fasciitis.
Methods
A multicenter retrospective chart review of patients undergoing MIS using the Tenex device from January 2020 to December 2022. The main data points collected were Patient-Reported Outcomes Measurement Information System (PROMIS), follow-up times, revision surgery, and complications.
Results
56 patients underwent 60 surgeries. The average age and BMI were 48.6 years (19–80), and 33.2 kg/m2 (19.7–58.6). The average follow-up was 27 months (13.3–48.6). The average improvement in pain, physical function, and mobility PROMIS scores were 5.2 (P < 0.01), 3.6 (P = 0.01), and 3.1 (P = 0.01).
Conclusion
MIS ultrasound-guided plantar fasciotomy appears to be a reliable surgical treatment option for chronic plantar fasciitis with high patient satisfaction and safety profile.
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NewsBot · Dec 21, 2025

Safety and Feasibility of the Plantar Portal Technique in the Surgical Management of Plantar Fasciitis: A Cadaveric Study
Edip Yilmaz et al
J Foot Ankle Res. 2025 Dec;18(4):e70105.

Introduction: This study investigates the proximity of the portals and nearby motor and sensory nerves in endoscopic release of the plantar fascia and the safety and efficacy of the addition of a novel third (plantar) portal to improve access to the calcaneal spur.

Methods: Nine fresh-frozen lower extremity cadavers were examined in this study. In addition to the conventional medial and lateral portals for endoscopic plantar fascia release, a third (plantar) portal was utilized to debride the calcaneal spur area. The fascia was released with the use of an obturator cannula. Each cadaver was carefully dissected, the distance of the nerves to the portals and the obturator cannula was measured with a digital caliper, and the adequacy of the plantar fascial cut was evaluated. The nerves were examined along their course to check for any injuries.

Result: The closest distance between the lateral plantar nerve and the plantar portal was 15.3 ± 1.47 mm, and the obturator cannula was 10.53 ± 1.50 mm. The closest distance between the first branch of the lateral plantar nerve (Baxter's nerve) and the obturator cannula was 10.02 ± 0.65 mm. The closest distance between Baxter's nerve and the calcaneal spur area was 8.21 ± 1.12 mm. There was no evidence of nerve or muscle injury in the dissected cadavers.

Conclusions: Using the plantar portal in conjunction with conventional portals in endoscopic plantar fasciitis surgery can be advantageous, as it provides easier access to the calcaneal spur and is safe in terms of its distance from the nearby neural structures
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NewsBot · Dec 27, 2025

Clinical Outcomes of Percutaneous
Plantar Fasciotomy in Patients
with Refractory Plantar Fasciitis:
a Retrospective Cohort Study
Konstantine M. BALALIS et al
Source

Background: Plantar fasciitis is the most common cause of chronic heel pain. Accurate diagnosis is
essential, as similar symptoms may arise from other conditions. Surgery is considered after six months of
failed conservative treatment, with various techniques available. This retrospective study aimed to evaluate
the outcomes of percutaneous plantar fascia release under local anesthesia in patients with plantar fasciitis.
Methods: This retrospective study included adult patients diagnosed with plantar fasciitis – based
on clinical and radiological evaluation – who underwent percutaneous plantar fascia release under local
anesthesia between 2017 and 2020 in our Outpatient Orthopedic Clinic. Patients with previous foot
surgeries, infections, tumours, systemic conditions (rheumatoid arthritis), or bilateral involvement were
excluded. All had persistent symptoms for over six months despite conservative treatment. Data collected
included demographics, symptom duration, body mass index (BMI), pain characteristics and functional
limitations. Outcomes were assessed using the visual analog scale (VAS) and subjective patient satisfaction.
Statistical analysis was performed using comparisons of means and the Chi-square test.
Results: Twenty-three patients (15 women and eight men with a mean age of 50 years, range 39–78)
underwent percutaneous plantar fascia release. The mean preoperative VAS score was 8.9 (range: 8–10)
for pain, and 8.5 (range: 8–10) for daily activity limitation,. At six months postoperatively, the average
VAS score decreased to 1.9 (range: 1–7) for pain and 1.6 (range: 1–6) for activity limitation, based on a
telephone survey using the Benton–Weil questionnaire. Two patients (8.7%) reported persistent pain and
dissatisfaction. The remaining 21 patients (91.3%) reported satisfactory outcomes. No correlation between
spur size and outcomes was found. Statistical analysis showed a significant improvement in both pain and
function (p < 0.05)
Conclusions: Percutaneous plantar fasciotomy is a safe and effective treatment for plantar fasciitis.
Further studies are needed to determine the optimal extent of fascial release and to refine patient selection
criteria.
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NewsBot · Jan 15, 2026 at 6:56 PM

Clinical Outcomes of Percutaneous Plantar Fasciotomy in Patients with Refractory Plantar Fasciitis: a Retrospective Cohort Study
Konstantine M Balalis et al
Maedica (Bucur). 2025 Dec;20(4):753-758.

Background: Plantar fasciitis is the most common cause of chronic heel pain. Accurate diagnosis is essential, as similar symptoms may arise from other conditions. Surgery is considered after six months of failed conservative treatment, with various techniques available. This retrospective study aimed to evaluate the outcomes of percutaneous plantar fascia release under local anesthesia in patients with plantar fasciitis.

Methods: This retrospective study included adult patients diagnosed with plantar fasciitis - based on clinical and radiological evaluation - who underwent percutaneous plantar fascia release under local anesthesia between 2017 and 2020 in our Outpatient Orthopedic Clinic. Patients with previous foot surgeries, infections, tumours, systemic conditions (rheumatoid arthritis), or bilateral involvement were excluded. All had persistent symptoms for over six months despite conservative treatment. Data collected included demographics, symptom duration, body mass index (BMI), pain characteristics and functional limitations. Outcomes were assessed using the visual analog scale (VAS) and subjective patient satisfaction. Statistical analysis was performed using comparisons of means and the Chi-square test.

Results: Twenty-three patients (15 women and eight men with a mean age of 50 years, range 39-78) underwent percutaneous plantar fascia release. The mean preoperative VAS score was 8.9 (range: 8-10) for pain, and 8.5 (range: 8-10) for daily activity limitation,. At six months postoperatively, the average VAS score decreased to 1.9 (range: 1-7) for pain and 1.6 (range: 1-6) for activity limitation, based on a telephone survey using the Benton-Weil questionnaire. Two patients (8.7%) reported persistent pain and dissatisfaction. The remaining 21 patients (91.3%) reported satisfactory outcomes. No correlation between spur size and outcomes was found. Statistical analysis showed a significant improvement in both pain and function (p < 0.05).

Conclusions: Percutaneous plantar fasciotomy is a safe and effective treatment for plantar fasciitis. Further studies are needed to determine the optimal extent of fascial release and to refine patient selection criteria.
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Endoscopic Partial Plantar Fasciotomy for Plantar Fasciitis

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Neuroma recurrence after endoscopic decompression

Endoscopic Release of Master Knot of Henry

Shock wave versus endoscopic plantar fascial release for resistant plantar fasciitis

Endoscopic style surgery for neuroma?

Partial nail avulsion not worked?

college athlete playing on partial PF tear??

Crazy itching after partial nail removal

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Endoscopic Partial Plantar Fasciotomy for Plantar Fasciitis

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Neuroma recurrence after endoscopic decompression

Endoscopic Release of Master Knot of Henry

Shock wave versus endoscopic plantar fascial release for resistant plantar fasciitis

Endoscopic style surgery for neuroma?

Partial nail avulsion not worked?

college athlete playing on partial PF tear??

Crazy itching after partial nail removal

Share This Page

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