Comparison of Endoscopic Plantar Fascia Release With and Without Calcaneal Spur Excision for Recalcitrant Plantar Fasciitis.

BACKGROUND

Endoscopic plantar fascia release (EPFR) is a common surgical option for recalcitrant plantar fasciitis. Although calcaneal spur excision (CSE) is frequently performed as an adjunct, its added clinical benefit remains unclear. This study compared outcomes of EPFR alone vs EPFR combined with CSE.

METHODS

This retrospective study included 23 patients (30 feet) who underwent endoscopic surgery for plantar fasciitis between 2017 and 2024. Patients were divided into 2 groups according to surgical procedure performed: EPFR (n = 22 feet) and EPFR+CSE (n = 8 feet). Pain and functional outcomes were assessed pre- and postoperatively using the visual analog scale (VAS), first-step VAS, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, and Foot Function Index (FFI).

RESULTS

Both procedures were associated with significant postoperative improvement in pain and function (all P < .001). Mean VAS scores improved from 6.2 to 1.5 in the EPFR group and from 6.4 to 1.2 in the EPFR+CSE group. AOFAS scores increased from 66.4 to 95.3 and from 64.5 to 94.5, respectively. Postoperative FFI values decreased from approximately 107 to 30 in both groups. However, comparison between groups revealed no statistically significant differences for any parameter (VAS p = 0.24; AOFAS p = 0.23; FFI p = 0.61). No recurrence or complications were observed.

CONCLUSION

EPFR, with or without CSE, was associated with clinical and functional improvement. With the numbers available, no additional benefit of CSE could be detected.

LEVEL OF EVIDENCE: Level III, retrospective comparative study.