This article is more than 5 years old. Information may no longer be current.
Gastrocnemius proximal release effective for chronic plantar fasciitis in initial results
Click Here to Manage Email Alerts
CHICAGO — Researchers who compared the general health outcomes in patients with chronic plantar fasciitis treated with either isolated gastrocnemius proximal release or partial proximal fasciotomy found increased satisfaction, better general postoperative results and a more rapid return to play and work in the group that underwent gastrocnemius proximal release.
“The role of this study was to address the isolated proximal medial gastrocnemius resection in the treatment of chronic plantar fasciitis,” Manuel Monteagudo, MD, said at the International Federation of Foot & Ankle Societies Triennial Meeting, here.
Monteagudo and colleagues conducted the prospective study, which followed their first 50 patients who underwent the gastrocnemius proximal release.
Patient satisfaction is key
There is a considerable difference between results with the two surgical techniques (gastrocnemius proximal release vs. partial proximal fasciotomy), according to Monteagudo. Patients in the gastrocnemius proximal release group reported a 95% satisfaction rate and would recommend the procedure to friends, he said.
“The isolated proximal medial gastrocnemius resection is a safer, more effective procedure than fasciotomy and patients are happier with this, as well,” Monteagudo said.
Image: Monteagudo M
Monteagudo and colleagues noted in the study about 25% of patients undergoing partial proximal fasciotomy did not get completely better after the procedure, which led them to perform gastrocnemius proximal releases in 50 patients with chronic plantar fasciitis and compare the results for the two groups.
In all, 11 preoperative and postoperative variables were examined and the VAS, Likert, and American Orthopaedic Foot and Ankle Society scale scores were used to evaluate the results.
The researchers found that patients undergoing the study procedure reported better health outcomes than patients undergoing partial proximal fasciotomy.
Patients treated with the fasciotomy technique reported about a 60% satisfactory rate, Monteagudo said, and they returned to work and sports at 10 weeks postoperatively on average compared to patients with a gastrocnemius proximal release, who had higher satisfaction rates and returned to work and sports in 3 weeks on average.
Postoperative outcomes favorable
“Improvement with respect to preoperative situations started to be shown just a few weeks following the procedure,” Monteagudo said of the proximal release. “There was a significant important improvement in terms of function and pain with respect to the preoperative conditions. This accounts for patient satisfaction. About 95% of patients deemed it satisfactory 6 months from surgery and would recommend the procedure to a friend,” he said.
The complication rate for the isolated release was low. Only one patient developed a calf hematoma, according to Monteagudo, who noted the procedure is fairly cost-effective compared with partial proximal fasciotomy. Although there might be some potential concern for the loss of calf power following the gastrocnemius release, he said this did not occur in any of the patients in the study group. Monteagudo said some patients were professional athletes. – by Robert Linnehan
- Reference:
- Monteagudo M. Gastrocnemius proximal release in the treatment of chronic plantar fasciitis: A prospective study of our first 50 cases. Presented at: International Federation of Foot & Ankle Societies Triennial Meeting; Sept. 19-21, 2014; Chicago.
- For more information:
- Manuel Monteagudo, MD, can be reached at the Orthopaedic Foot and Ankle Unit, Orthopaedics and Trauma Department, Hospital Universitario Quiron Madrid, Calle Diego de Velázquez 1, Pozuelo de Alarcón, Madrid, Spain; email: mmontyr@yahoo.com.
Disclosure: Monteagudo has no relevant financial disclosures.