A Novel Indigenous Endoscopic-Assisted Surgery for Intractable Plantar Fasciitis: A Case Series

Plantar fasciitis is the most common cause of heel pain in adults, and while most cases respond to conservative treatment, a subset of patients require surgical intervention. Endoscopic plantar fascia release (EPFR) is preferred for its minimally invasive nature and favorable outcomes. However, the cost of disposable instrumentation presents a barrier in low-resource settings. This study aims to evaluate the clinical effectiveness and safety of endoscopic plantar fascia release using reusable, affordable, autoclavable instruments developed as a cost-conscious alternative to disposable kits.

This prospective case series included 24 patients with intractable plantar fasciitis who underwent EPFR using reusable instruments between April 2019 and March 2024. Patients were assessed preoperatively and at 12 months postoperatively using the AOFAS Hindfoot Score and the VAS for pain. Data were analyzed using paired t tests with significance set at p < 0.05.

The mean preoperative AOFAS score improved from 59.2 ± 3.8 to 84.4 ± 6.0 postoperatively (p < .001), and the mean VAS score decreased from 8.1 ± 1.7 to 2.4 ± 0.5 (p < .001). Pain relief was reported by 91.7% of patients. No major complications were observed.

Endoscopic plantar fascia release using reusable instruments is a safe and effective surgical option, providing significant pain relief and functional improvement. The use of reusable instruments offers a practical and potentially more affordable alternative in resource-limited settings.Level of evidence: IV.