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Histological changes of the plantar aponeurosis enthesis in plantar fasciitis Home > Vol 20, No 5 (2019)
Background. We have made the analysis of the plantar aponeurosis enthesis histology results in patients with plantar fasciitis. Materials and methods. Four samples of the plantar aponeurosis enthesis were obtained for histology assessment from 3 patients with chronic plantar fasciitis during aponeurotomy. All patients were males with average age of 34.6 ± 12.6 (range 21–57) years. Fragments of the tendon-bone junction were selected for histologic examination. Paraffin sections (5 micron) were analyzed with bright-field microscopy (Olympus CX-41). Grades of severity of morphological signs were evaluated by visual analogue scale from low to high at 100× magnification. Results. The material in plantar aponeurosis biopsies was represented by fragments of pathologically altered connective tissue with small areas of interstitial tendonecrosis, changes in the regularity and density of collagen fibers. There is a large amount of hypercellular proliferations of fibroadipose tissue, the appearance of vessels and areas of indistinctly restricted fibronecrosis. No signs of acute or chronic inflammation were found, there were only manifestations of non-specific enthesopathy of fibrocartilaginous enthesis. Conclusions. The histological changes in the tissue of the plantar aponeurosis enthesis in patients with plantar fasciitis correspond to the chronic non-specific dystrophic degenerative changes in the fibrocartilaginous structure of the enthesis, tendinitis-fasciitis of secondary origin.
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