Endoscopic debridement of chronic plantar fasciitis with heel spur resection – a prospective cohort study

Introduction. Chronic plantar fasciitis is often resistant to conservative treatments. While studies have explored endoscopic debridement with heel spur resection, further evaluation is needed due to limited data.Aim. The challenge of treating recalcitrant plantar fasciitis, unresponsive to nonopera...

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Main Authors: Patrick Buliński, Bartosz Bartosz, Artur Banach, Pavle Milanovic, Sorin Barbu, Jakub Naczk, Tomasz Piontek
Format: Article
Language:English
Published: Polish Society of Orthopaedics and Traumatology (PTOiTr) 2025-03-01
Series:Chirurgia Narządów Ruchu i Ortopedia Polska
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Online Access:http://polishorthopaedics.pl/gicid/01.3001.0055.0522
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author Patrick Buliński
Bartosz Bartosz
Artur Banach
Pavle Milanovic
Sorin Barbu
Jakub Naczk
Tomasz Piontek
author_facet Patrick Buliński
Bartosz Bartosz
Artur Banach
Pavle Milanovic
Sorin Barbu
Jakub Naczk
Tomasz Piontek
author_sort Patrick Buliński
collection DOAJ
description Introduction. Chronic plantar fasciitis is often resistant to conservative treatments. While studies have explored endoscopic debridement with heel spur resection, further evaluation is needed due to limited data.Aim. The challenge of treating recalcitrant plantar fasciitis, unresponsive to nonoperative treatments, has necessitated exploring innovative surgical techniques. This study examines a novel operative method that focuses on endoscopic debriding the pathologically altered tissue in the plantar fascia with heel spur resection, preserving the integrity of the aponeurosis to prevent adverse effects on the foot’s biomechanics. The main objective is to evaluate this technique’s efficacy in reducing pain and improving functional outcomes.Methods and materials. A prospective study was conducted on 18 patients (25 feet) with chronic plantar fasciitis unresponsive to conservative treatment for at least 6 months. The patients underwent endoscopic debridement with heel spur resection between 2013 and 2023 at our orthopedic clinic. Preoperative and postoperative outcomes were assessed using the American Orthopedic Foot and Ankle Score (AOFAS) scale at baseline and 3 and 6 months postoperatively. Statistical analysis included the Shapiro-Wilk test for normality and paired t-tests to evaluate the significance of changes in AOFAS scores.Results. Postoperative assessments showed a significant improvement in AOFAS scores, with the mean score increasing from 52.48 5.93 preoperatively to 90.80 4.93 at 3 months and 92.92 3.65 at 6 months postoperatively (p < 0.001). These findings indicate a substantial reduction in pain and enhancement in functional abilities.Conclusions. Endoscopic debridement of the plantar fascia with heel spur resection is a promising, minimally invasive option for chronic plantar fasciitis unresponsive to conservative treatment. However, due to the relatively small sample size and lack of a control group, further studies with larger cohorts and comparisons to traditional approaches are needed to fully understand its impact on foot biomechanics.
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spelling doaj-art-97dfde41c43b4756b7f99b2a83d78cf22025-08-20T01:54:29ZengPolish Society of Orthopaedics and Traumatology (PTOiTr)Chirurgia Narządów Ruchu i Ortopedia Polska0009-479X2956-47192025-03-01901566310.31139/chnriop.2025.90.1.501.3001.0055.0522Endoscopic debridement of chronic plantar fasciitis with heel spur resection – a prospective cohort studyPatrick Buliński0Bartosz Bartosz1Artur Banach2Pavle Milanovic3Sorin Barbu4Jakub Naczk5Tomasz Piontek6Rehasport Clinic, Poznań, PolandDepartment of Orthopaedic, Pediatric Orthopaedic and Traumatology, Medical Centre of Postgraduate Education, Warsaw-Otwock, PolandMICROBS Lab, School of Engineering, Ecole Polytechnique Federale de Lausanne, Lausanne, SwitzerlandDepartment of Orthopedics and Trauma Surgery, University Clinical Center Niš, Niš, SerbiaDepartment of Orthopaedics and Trauma Surgery, University Clinical Hospital Craiova, RomaniaRehasport Clinic, Poznań, PolandRehasport Clinic, Poznań, PolandIntroduction. Chronic plantar fasciitis is often resistant to conservative treatments. While studies have explored endoscopic debridement with heel spur resection, further evaluation is needed due to limited data.Aim. The challenge of treating recalcitrant plantar fasciitis, unresponsive to nonoperative treatments, has necessitated exploring innovative surgical techniques. This study examines a novel operative method that focuses on endoscopic debriding the pathologically altered tissue in the plantar fascia with heel spur resection, preserving the integrity of the aponeurosis to prevent adverse effects on the foot’s biomechanics. The main objective is to evaluate this technique’s efficacy in reducing pain and improving functional outcomes.Methods and materials. A prospective study was conducted on 18 patients (25 feet) with chronic plantar fasciitis unresponsive to conservative treatment for at least 6 months. The patients underwent endoscopic debridement with heel spur resection between 2013 and 2023 at our orthopedic clinic. Preoperative and postoperative outcomes were assessed using the American Orthopedic Foot and Ankle Score (AOFAS) scale at baseline and 3 and 6 months postoperatively. Statistical analysis included the Shapiro-Wilk test for normality and paired t-tests to evaluate the significance of changes in AOFAS scores.Results. Postoperative assessments showed a significant improvement in AOFAS scores, with the mean score increasing from 52.48 5.93 preoperatively to 90.80 4.93 at 3 months and 92.92 3.65 at 6 months postoperatively (p < 0.001). These findings indicate a substantial reduction in pain and enhancement in functional abilities.Conclusions. Endoscopic debridement of the plantar fascia with heel spur resection is a promising, minimally invasive option for chronic plantar fasciitis unresponsive to conservative treatment. However, due to the relatively small sample size and lack of a control group, further studies with larger cohorts and comparisons to traditional approaches are needed to fully understand its impact on foot biomechanics.http://polishorthopaedics.pl/gicid/01.3001.0055.0522endoscopic plantar fasciotomychronic plantar fasciitisheel spurcalcaneal spur
spellingShingle Patrick Buliński
Bartosz Bartosz
Artur Banach
Pavle Milanovic
Sorin Barbu
Jakub Naczk
Tomasz Piontek
Endoscopic debridement of chronic plantar fasciitis with heel spur resection – a prospective cohort study
Chirurgia Narządów Ruchu i Ortopedia Polska
endoscopic plantar fasciotomy
chronic plantar fasciitis
heel spur
calcaneal spur
title Endoscopic debridement of chronic plantar fasciitis with heel spur resection – a prospective cohort study
title_full Endoscopic debridement of chronic plantar fasciitis with heel spur resection – a prospective cohort study
title_fullStr Endoscopic debridement of chronic plantar fasciitis with heel spur resection – a prospective cohort study
title_full_unstemmed Endoscopic debridement of chronic plantar fasciitis with heel spur resection – a prospective cohort study
title_short Endoscopic debridement of chronic plantar fasciitis with heel spur resection – a prospective cohort study
title_sort endoscopic debridement of chronic plantar fasciitis with heel spur resection a prospective cohort study
topic endoscopic plantar fasciotomy
chronic plantar fasciitis
heel spur
calcaneal spur
url http://polishorthopaedics.pl/gicid/01.3001.0055.0522
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