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Mid-term Patient-Reported Outcomes Following Isolated Gastrocnemius Recession for Recalcitrant Plantar Fasciitis
Matthew R Rohl1, Joseph Long2, Brent Whitehead3
1Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA.
Background:
Most patients with plantar fasciitis experience symptom relief with nonoperative management. However, a subset remains refractory to conservative treatments and may benefit from surgical intervention. Prior studies support the use of isolated gastrocnemius recession, demonstrating favorable short-term outcomes and low complication rates. Herein we assessed the outcomes following an isolated gastrocnemius recession for recalcitrant plantar fasciitis extended to midterm outcomes (36-89 months).
Methods:
Eighty-eight patients who underwent isolated gastrocnemius recession for recalcitrant plantar fasciitis between September 2014 and June 2017 were identified through procedural codes. Patients were contacted by phone to complete the Foot and Ankle Ability Measure (FAAM) and American Academy of Orthopaedic Surgeons (AAOS) Foot and Ankle Outcomes Questionnaire, and to report satisfaction, willingness to repeat the procedure, and willingness to recommend it.
Results:
Of 88 eligible patients, 43 completed follow-up (33 females, 10 males) at a mean of 5.0 ± 1.3 years postoperatively. Mean FAAM scores were 92.0 ± 15.0 for activities of daily living and 86.2 ± 24.2 for sports; mean ADL daily function was 91.0% ± 19.8%, with 39 patients reporting normal or near-normal function. Mean AAOS standardized norm-based score was 93.9 ± 11.4, and mean shoe comfort score was 83.5 ± 25.8. Among the 23 patients who provided pain data, mean VAS was 1/10, with 87% rating pain ≤2/10. Overall satisfaction was high: 95% were satisfied, 93% would undergo the procedure again, and 91% would recommend it. One patient required revision gastrocnemius recession with subsequent symptom resolution.
Conclusion:
Isolated gastrocnemius recession for recalcitrant plantar fasciitis was associated with durable midterm outcomes with high patient satisfaction, substantial functional scores, and low complication rates. These findings support its use in patients who fail conservative management.
Level Of Evidence:
Level IV, therapeutic.