Introduction:
Plantar fasciitis is caused by inflammation of the plantar fascia, which is the most common cause of heel pain. The bottom of the foot contains a thick band of tissue known as the plantar fascia. It extends from the heel bone to the toe. The condition usually occurs due to overuse or strain of the plantar fascia. Symptoms of plantar fasciitis include pain and tenderness in the heel or arch, especially when taking the first few steps in the morning or after sitting for extended periods. The plantar fascia helps support the foot arch and provides shock absorption during walking, running, and jumping.
What Is Endoscopic Plantar Fasciotomy?
Endoscopic plantar fasciotomy is a minimally invasive surgical option. A tiny camera, called an endoscope, is used to visualize the plantar fascia and release it through small incisions in the foot. This procedure can be less painful and result in faster recovery than an open incision. Conservative treatment, like orthotic devices or heel pads, painkillers, corticosteroid injections, and physical therapy, may relieve 80 percent of cases. Individuals not responding to conservative methods will go for surgical options like endoscopic plantar fasciotomy.
Who Is Eligible for Endoscopic Plantar Fasciotomy?
Endoscopic plantar fasciotomy is typically recommended for patients with chronic plantar fasciitis that has not responded to non-surgical treatments such as physical therapy, orthotics, or anti-inflammatory medication. The procedure is also used for some cases, which include the following.
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Individuals with severe heel pain that interferes with daily activities.
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Those who cannot continue physical activities due to the pain.
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Individuals who have these symptoms for six months or more.
Certain factors cause some risks, complications, or delay the recovery period, which include:
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Diabetes is caused by the body's inability to produce or effectively use insulin, a hormone that regulates blood sugar levels. Type 1 and type 2 are the two primary categories of diabetes.
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Venous Insufficiency: It is caused by the body's inability to produce or effectively use insulin, a hormone that regulates blood sugar levels.
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Peripheral Neuropathy is nerve damage affecting the peripheral nervous system, responsible for transmitting sensory information between the body and the brain.
How to Perform Endoscopic Plantar Fasciotomy?
The endoscopic plantar fasciotomy procedure is usually outpatient and takes about an hour to complete. The patient is placed under local or regional anesthesia, and a small incision is made on the side of the heel. A cannula (a slotted tube) is placed through the incision against the plantar fascia. The entire procedure is done with the help of a cannula. The endoscope (a medical device with a flexible tube equipped with a camera and light source) is inserted through the incision. The surgeon uses it to visualize the damaged portion of the plantar fascia. A small scalpel or laser removes the damaged tissue, and the endoscope is removed. Once the incision has been sutured, dressing and a splint are applied to the foot.
What Are the Different Types of Plantar Fasciitis Surgery?
Surgical options for plantar fasciitis relieve pressure and tension on the plantar fascia, reduce pain and inflammation, and correct any underlying foot structure problems.
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Plantar Fascia Release Surgery: This procedure involves cutting part of the plantar fascia (the thick band of tissue that extends from the heel to the toes) to relieve tension and reduce pain. The goal is to alleviate pressure on the fascia and reduce inflammation, causing pain. This procedure can be done through an open incision or minimally invasively using endoscopic techniques.
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Stabilization Surgery: This procedure involves repairing the ligaments and other structures that support the foot's arch to provide stability and reduce stress on the plantar fascia. The goal is to correct foot structure problems that may contribute to the development of plantar fasciitis.
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Calcaneal Osteotomy: This procedure involves cutting the calcaneus (the heel bone) to realign the foot and reduce stress on the plantar fascia. This is typically done in cases where the heel bone has shifted out of its normal position, causing excessive pressure on the plantar fascia.
What Are the Benefits of Endoscopic Plantar Fasciotomy?
Endoscopic plantar fasciotomy has several advantages over traditional open surgery, including:
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Minimal Incision: The endoscopic procedure minimizes the risk of scarring and infection by making a small incision.
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Quick Recovery Period: Endoscopic plantar fasciotomy allows faster recovery than traditional surgery, enabling patients to return to normal activities sooner.
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Less Pain: Endoscopic plantar fasciotomy causes less pain and discomfort than open surgery.
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Improves Accuracy: The endoscope provides the surgeon with a clear view of the damaged tissue, enabling them to remove only the affected area and preserve healthy tissue.
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Better Cosmetic Results: The small incision and minimally invasive nature of endoscopic plantar fasciotomy result in a more aesthetically pleasing outcome than open surgery.
How Long Is the Recovery Time for Endoscopic Plantar Fasciotomy?
The recovery process after endoscopic plantar fasciotomy is relatively quick and painless compared to traditional open surgery. Most patients can return to normal activities within a few weeks. However, complete recovery typically takes about three to six months. During the recovery period, healthcare professionals will suggest post-operative instructions, which include wearing a splint or brace, using crutches or a walker, and avoiding weight-bearing activities for a specified period. In addition, physical therapy and other rehabilitation exercises are recommended to promote healing and improve the flexibility and strength of the foot and ankle.
Conclusion:
Endoscopic plantar fasciotomy is an effective and minimally invasive surgical procedure for treating plantar fasciitis. This procedure offers several advantages over traditional surgical methods, including minimal incision, quicker recovery, less pain, improved accuracy, and better cosmetic results. The choice of procedure depends on the individual patient's condition and needs. However, not all patients with plantar fasciitis may require surgery, as conservative treatments have to be tried first. Surgical intervention is the best choice if conservative treatments cannot manage the condition.
