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. 2023 Aug;143(8):4641-4651.
doi: 10.1007/s00402-022-04739-0. Epub 2023 Jan 3.

Surgical treatment options for plantar fasciitis and their effectiveness: a systematic review and network meta-analysis

Sandeep Krishan Nayar  1 , Harry Alcock  2 , Krishna Vemulapalli  2
Affiliations

Surgical treatment options for plantar fasciitis and their effectiveness: a systematic review and network meta-analysis

Sandeep Krishan Nayar et al. Arch Orthop Trauma Surg. 2023 Aug.

Abstract

Background: To date, there are no systematic reviews on the utility of surgical management for plantar fasciitis to guide best practice. This review aimed to evaluate the operative options for plantar fasciitis and their effectiveness.

Methods: A systematic review and network meta-analysis were carried out in accordance with PRISMA guidelines. A search strategy was conducted on the MEDLINE, EMBASE, and Cochrane databases. Quality was assessed using the ROBINS-I tool.

Results: 17 studies involving 865 patients were included. Surgical options considered were open and endoscopic plantar fasciotomy, gastrocnemius release, radiofrequency microtenotomy and dry needling. All interventions resulted in improvement in VAS and AOFAS scores. No major complications were seen from any treatment modality.

Conclusions: Surgical interventions are effective in providing short- to medium-term symptomatic relief for plantar fasciitis refractory to non-operative management. Current evidence is equivocal regarding treatment choice. Further large randomised studies are required to establish long-term outcomes and a management algorithm.

Level of evidence: Level III.

Keywords: Gastrocnemius release; Plantar fasciitis; Plantar fasciotomy; Radiofrequency microtenotomy.

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