Endoscopic Plantar Fascia Release Versus Cryosurgery for The Treatment of Chronic Plantar Fasciitis: A Prospective Randomized Study.

Abstract

BACKGROUND: In the present randomized prospective study, 2 different surgical techniques of plantar fasciitis surgery were compared. METHODS: Forty-eight patients who were diagnosed as plantar fasciitis and treated conservatively for at least 6 months and had no response to conservative treatment modalities were involved in this study. The patients were randomly assigned to endoscopic plantar fascia release (EPFR group) or cryosurgery (CS group). Patients were evaluated using American Orthopaedic Foot and Ankle Society ankle/hindfoot scale (AOFAS-AHS) as a primary outcome measurement at baseline and 3 weeks and 3, 6, and 12 months after the initial surgery. At the final follow-up appointment, the Roles- Maudsley score was used to determine patient satisfaction. RESULTS: Five patients did not complete the 1-year follow-up examination (1 in EPFR group and 4 in CS group). Thus, the study group included 43 patients. While both groups were showed significant improvement at the final evaluation, the patients undergoing EPFR had significantly greater AOFAS-AHS scores after 3 months postoperatively. The success rate (Roles and Maudsley score excellent and good) in the ESWT group at month 12 was 87 %, while in the CS group, the success rate was 65%. CONCLUSIONS: Both EPFR and CS were associated with statistically significant improvements at 1-year follow-up, but after 3 months postoperatively, EPFR was associated with better results and higher patient s satisfaction rate when compared with CS.