Foot Arch Changes after Endoscopic Plantar Fascia Release for Recalcitrant Plantar Fasciitis
INTRODUCTION: Endoscopic plantar fascia release (EPFR) is a minimally invasive surgical intervention for recalcitrant plantar fasciitis. Its efficacy has been convincing but the in vivo effect on medial longitudinal foot arch and footprint has not been studied. Our objective is to evaluate the chang...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Malaysian Orthopaedic Association
2022-07-01
|
| Series: | Malaysian Orthopaedic Journal |
| Subjects: | |
| Online Access: | http://morthoj.org/2022/v16n2/endoscopic-plantar-fascia.pdf |
| _version_ | 1828151732338688000 |
|---|---|
| author | Liew SK Saw A Chua YP |
| author_facet | Liew SK Saw A Chua YP |
| author_sort | Liew SK |
| collection | DOAJ |
| description | INTRODUCTION: Endoscopic plantar fascia release (EPFR) is a minimally invasive surgical intervention for recalcitrant plantar fasciitis. Its efficacy has been convincing but the in vivo effect on medial longitudinal foot arch and footprint has not been studied. Our objective is to evaluate the changes of foot posture using radiographs and footprints following endoscopic plantar fascia release in recalcitrant plantar fasciitis.
MATERIALS AND METHODS: This prospective cohort involved patients with recalcitrant plantar fasciitis who failed six months of conservative treatment. Two-portal endoscopic release of not more than 50% of plantar fascia width was performed. Footprint and standard weight-bearing anteroposterior and lateral radiographs of the foot were taken pre-operatively and at 12 months post-surgery. Arch index, normalised navicular height truncated, calcaneal inclination angle, calcano-1st metatarsal angle, talonavicular coverage angle and talus-2nd metatarsal angle were measured.
RESULTS: Sixteen patients (18 feet) were reported. Patients’ follow-up ranged from 14 to 31 months after surgery (mean±SD: 23.44±5.76). The increase of arch index, calcano-1st metatarsal angle and reduction of calcaneal inclination angle were found statistically significant (p<0.05). Two normal arch patients progressed to asymptomatic flat arch feet. Three complications were noted between three to nine months post-surgery, one with medial column and two with lateral column symptoms.
CONCLUSION: There is evidence of reduction in medial longitudinal arch of the foot after EPFR. Although the reduction remains asymptomatic, post-operative complications related to changes in biomechanics of the foot can occur between three to nine months. Patients should be monitored at least for 12 months and longer for those who are symptomatic. |
| first_indexed | 2024-04-11T22:01:52Z |
| format | Article |
| id | doaj.art-f0dc8fb7646342d693204844569046bc |
| institution | Directory Open Access Journal |
| issn | 1985-2533 2232-111X |
| language | English |
| last_indexed | 2024-04-11T22:01:52Z |
| publishDate | 2022-07-01 |
| publisher | Malaysian Orthopaedic Association |
| record_format | Article |
| series | Malaysian Orthopaedic Journal |
| spelling | doaj.art-f0dc8fb7646342d693204844569046bc2022-12-22T04:00:55ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2022-07-01162788610.5704/MOJ.2207.010Foot Arch Changes after Endoscopic Plantar Fascia Release for Recalcitrant Plantar FasciitisLiew SK 0Saw A1Chua YP2MS OrthFRCSIMS OrthINTRODUCTION: Endoscopic plantar fascia release (EPFR) is a minimally invasive surgical intervention for recalcitrant plantar fasciitis. Its efficacy has been convincing but the in vivo effect on medial longitudinal foot arch and footprint has not been studied. Our objective is to evaluate the changes of foot posture using radiographs and footprints following endoscopic plantar fascia release in recalcitrant plantar fasciitis. MATERIALS AND METHODS: This prospective cohort involved patients with recalcitrant plantar fasciitis who failed six months of conservative treatment. Two-portal endoscopic release of not more than 50% of plantar fascia width was performed. Footprint and standard weight-bearing anteroposterior and lateral radiographs of the foot were taken pre-operatively and at 12 months post-surgery. Arch index, normalised navicular height truncated, calcaneal inclination angle, calcano-1st metatarsal angle, talonavicular coverage angle and talus-2nd metatarsal angle were measured. RESULTS: Sixteen patients (18 feet) were reported. Patients’ follow-up ranged from 14 to 31 months after surgery (mean±SD: 23.44±5.76). The increase of arch index, calcano-1st metatarsal angle and reduction of calcaneal inclination angle were found statistically significant (p<0.05). Two normal arch patients progressed to asymptomatic flat arch feet. Three complications were noted between three to nine months post-surgery, one with medial column and two with lateral column symptoms. CONCLUSION: There is evidence of reduction in medial longitudinal arch of the foot after EPFR. Although the reduction remains asymptomatic, post-operative complications related to changes in biomechanics of the foot can occur between three to nine months. Patients should be monitored at least for 12 months and longer for those who are symptomatic.http://morthoj.org/2022/v16n2/endoscopic-plantar-fascia.pdfendoscopic plantar fascia releasefoot archfootprintplantar fasciitisradiological measurements |
| spellingShingle | Liew SK Saw A Chua YP Foot Arch Changes after Endoscopic Plantar Fascia Release for Recalcitrant Plantar Fasciitis Malaysian Orthopaedic Journal endoscopic plantar fascia release foot arch footprint plantar fasciitis radiological measurements |
| title | Foot Arch Changes after Endoscopic Plantar Fascia Release for Recalcitrant Plantar Fasciitis |
| title_full | Foot Arch Changes after Endoscopic Plantar Fascia Release for Recalcitrant Plantar Fasciitis |
| title_fullStr | Foot Arch Changes after Endoscopic Plantar Fascia Release for Recalcitrant Plantar Fasciitis |
| title_full_unstemmed | Foot Arch Changes after Endoscopic Plantar Fascia Release for Recalcitrant Plantar Fasciitis |
| title_short | Foot Arch Changes after Endoscopic Plantar Fascia Release for Recalcitrant Plantar Fasciitis |
| title_sort | foot arch changes after endoscopic plantar fascia release for recalcitrant plantar fasciitis |
| topic | endoscopic plantar fascia release foot arch footprint plantar fasciitis radiological measurements |
| url | http://morthoj.org/2022/v16n2/endoscopic-plantar-fascia.pdf |
| work_keys_str_mv | AT liewsk footarchchangesafterendoscopicplantarfasciareleaseforrecalcitrantplantarfasciitis AT sawa footarchchangesafterendoscopicplantarfasciareleaseforrecalcitrantplantarfasciitis AT chuayp footarchchangesafterendoscopicplantarfasciareleaseforrecalcitrantplantarfasciitis |