David Weijia Mao1, Darshana Chandrakumara2, Qishi Zheng3, Carmen Kam4, Charles Kon Kam King2. 1. Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, 529889, Singapore. Electronic address: dave.w.mao@gmail.com. 2. Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, 529889, Singapore. 3. Department of Epidemiology, Singapore Clinical Research Institute, 31 Biopolis Way, 138669, Singapore. 4. Clinical Trials & Research Unit, Changi General Hospital, 2 Simei St 3, 529889, Singapore.
Abstract
BACKGROUND: Currently, there is limited evidence on outcomes for endoscopic plantar fasciotomy. OBJECTIVES: An evidence-based literature review for outcomes of endoscopic plantar fasciotomy for the treatment of plantar fasciitis is provided. METHODS: A comprehensive evidence-based literature review of PubMed and Cochrane databases was conducted on 9th March 2019, which identified 12 relevant articles assessing the efficacy of endoscopic plantar fasciotomy. The studies were then assigned to a level of evidence (I-IV). Individual studies were reviewed to provide a grade of recommendation (A-C, I) according to the Wright classification in support of or against endoscopic plantar fascia release. RESULTS: Based on the results of this evidence-based review, there is poor evidence (grade C) to support endoscopic plantar fascia release. Release of the medial 2/3 of the plantar fascia in endoscopic plantar fasciotomy was associated with higher AOFAS score. CONCLUSION: Although the majority of the level of evidence was low (level IV) and grade of recommendation was poor (grade C), there seemed to be good outcomes for endoscopic plantar fasciotomy. There is a need for more high quality level I randomized controlled trials with validated outcome measures to allow for stronger recommendations to be made.
BACKGROUND: Currently, there is limited evidence on outcomes for endoscopic plantar fasciotomy. OBJECTIVES: An evidence-based literature review for outcomes of endoscopic plantar fasciotomy for the treatment of plantar fasciitis is provided. METHODS: A comprehensive evidence-based literature review of PubMed and Cochrane databases was conducted on 9th March 2019, which identified 12 relevant articles assessing the efficacy of endoscopic plantar fasciotomy. The studies were then assigned to a level of evidence (I-IV). Individual studies were reviewed to provide a grade of recommendation (A-C, I) according to the Wright classification in support of or against endoscopic plantar fascia release. RESULTS: Based on the results of this evidence-based review, there is poor evidence (grade C) to support endoscopic plantar fascia release. Release of the medial 2/3 of the plantar fascia in endoscopic plantar fasciotomy was associated with higher AOFAS score. CONCLUSION: Although the majority of the level of evidence was low (level IV) and grade of recommendation was poor (grade C), there seemed to be good outcomes for endoscopic plantar fasciotomy. There is a need for more high quality level I randomized controlled trials with validated outcome measures to allow for stronger recommendations to be made.