Percutaneous Partial Plantar Fascia Release as a Minimally Invasive Treatment Following Failure of Conservative Management for Chronic Plantar Fasciitis: A Prospective Study

Abstract

Background: Chronic recalcitrant plantar fasciitis influences 5–10% of patients who are unresponsive to conservative treatment, necessitating surgical intervention. Percutaneous partial plantar fascia release is an emerging minimally invasive technique, but there is limited prospective evidence available proving the safety and effectiveness of the technique under general anesthesia. Objective: To evaluate the clinical outcomes, safety, and efficacy of percutaneous partial plantar fascia release done under general anesthesia. Methods: This prospective interventional study comprised 32 patients with chronic plantar fasciitis, unresponsive to a minimum of six months of conservative management. All patients underwent percutaneous medial plantar fascia release under general anesthesia. We used the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) score to measure the outcomes of surgical intervention at baseline and six months after surgery. Results: The mean VAS score decreased from 8.1±0.9 preoperatively to 1.6±0.8 at six months after surgery (−6.5; p<0.001). The mean AOFAS score increased from 46.73±8.73 to 93.80±10.46 (47.07; p<0.001). There was no significant difference between the patients with calcaneal spur and those without it (p > 0.05). Complications were infrequent (6.25%). Conclusions: Percutaneous partial release of the plantar fascia under general anesthesia is a safe and effective minimally invasive procedure for chronic plantar fasciitis that provides significant pain relief and improves functional status with a minimal incidence of complications. Large-scale comparative studies with extended follow-up are needed.