Retrospective study investigating the effect of isolated proximal medial gastrocnemius release for recalcitrant plantar fasciitis.

BACKGROUND

Plantar fasciitis (PF) is a well-known cause of inferior heel pain. Gastrocnemius tightness plays an important role in the pathophysiology. PF is mainly treated conservatively, but in a limited number of patients further surgery is needed. We investigated whether proximal medial gastrocnemius release (PMGR) as an isolated procedure is a successful treatment with low complication rates.

METHODS

This retrospective follow up included patients who underwent PMGR between August 2020 and December 2024 for recalcitrant PF. Diagnosis of PF was confirmed clinically and radiologically. A minimum of 6 months conservative treatment together with a positive Silfverskiöld's test was indicative for surgery. Pain and functional assessment were measured preoperatively, at 2 weeks and 2 years postoperatively using the European Foot and Ankle Society (EFAS) questionnaire and the Visual Analog Scale (VAS).

RESULTS

A total of 24 patients (34 feet) were included. The mean preoperative EFAS score improved from 1.79 ± 3.362-12.46 ± 7.14 at 2 weeks (P < 0.001) and to 22.08 ± 4.31 at 2 years postoperative (P < 0.001). The mean preoperative VAS score declined from 8.17 ± 1.05-4.67 ± 2.48 2 weeks postoperatively (P < 0.001) to 1.17 ± 2.51 2 years postoperatively (P < 0.001). There was 1 case of deep venous thrombosis with associated pulmonary embolism, no other complications were noted.

CONCLUSIONS

PMGR provides good results for patients with recalcitrant plantar fasciitis with a high satisfaction and low complication rate.