Comparison of the therapeutic outcomes between open plantar fascia release and percutaneous radiofrequency ablation in the treatment of intractable plantar fasciitis

Abstract

Background: Heel pain is one of the most common complaints in foot and ankle clinic, and one of the leading causes of heel pain is plantar fasciitis.

Methods: A retrospective analysis was carried out in 31 cases (39 feet) of patients with intractable plantar fasciitis. In the enrolled 26 cases, 16 patients (19 feet) received open plantar fascia release, and the other 15 patients (20 feet) received percutaneous radiofrequency ablation. The surgical results were assessed by visual analog scale (VAS) and American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AH) before and after surgery in all patients.

Results: All 31 patients were followed up successfully, with a mean follow-up time of 58.77 months. There were no differences of patient's demographics and characteristics information between the two groups. The average operative time of the feet in the open plantar fascia release is longer than that in the percutaneous radiofrequency ablation. Furthermore, the percutaneous radiofrequency ablation group had a shorter recovery time to normal activity than the open plantar fascia release group. There were no differences of postoperative VAS scores and the AOFAS-AH scores between the two groups. All patients reported satisfaction after either operation.

Conclusion: The symptoms of pain and limb function were significantly improved in patients both of the partial plantar fascia release treated group and the percutaneous radiofrequency ablation treated group. The two types of surgical procedures shared the same long-term curative effects. However, percutaneous radiofrequency ablation was a better technique from the point of shorter operative time and postoperative recovery time.

Trial registration: Retrospectively registered.

Keywords: Intractable plantar fasciitis; Open plantar fascia release; Percutaneous radiofrequency ablation.

Fig. 1

a An anatomical view of the tendon fascia. b1, b2 A schematic view of percutaneous fascia surgery. b1 The separation of the fascia with a stent. b2 The iridium fascia is cut by 1/2 along the stent groove with a blade. c1, c2 The surgical intent of radiofrequency ablation. The red dot in c1 is the position at which the ablation needle is inserted. c2 The depth at which the ablation needle is inserted

Fig. 2

The procedure of open plantar fascia release. a We marked the pain zone at first. b–f Dissection carried out through the skin and subcutaneous tissue and exposed the plantar fascia from medial hindfoot. Half of the medial plantar fascia was released through medial incision. e There was only a micro-wound left on the foot

Fig. 3

The procedure of percutaneous radiofrequency ablation. a We marked the pain zone the at first. b, c A 2-mm Kirschner wire was used as a puncture needle to puncture the skin and subcutaneous tissue at the marking points. Subsequently, a radiofrequency cutter was inserted to the plantar fascia level at each puncture point of the marked grid, and radiofrequency ablation was then performed percutaneously. d There was no obvious wound after operation