Evaluation of Long-term Outcomes Following Plantar Fasciotomy

Abstract

Background: Plantar fasciitis is a common condition prevalent in both athletic and nonathletic populations. Approximately 10% of patients do not respond to conservative treatment and suffer chronic recalcitrant plantar fasciitis. Outcomes following plantar fasciotomy vary but short-term studies have reported excellent early pain relief and return to activity, and significant improvements in symptoms. Previous study limitations include small patient cohorts, short-term duration of follow-up or lack of validated outcome measures. We therefore aimed to investigate the long-term outcomes following complete plantar fasciotomy. Methods: Patients who underwent complete plantar fasciotomy surgery from a single surgeon within the past 10 years (minimum 7 months) were invited to participate in this retrospective survey study. To evaluate patient-reported function, participants were asked to complete the Foot and Ankle Outcome Score (FAOS). To assess subjective outcome, the participants were provided a satisfaction survey. The satisfaction survey was designed to include the 3 key factors for assessing postoperative patient satisfaction, which are preoperative expectations, symptom relief, and hospital experience. A total of 74 questionnaires were returned. Results: The median global satisfaction score was 85.4 (IQR=37.5) points out of 100. Significant correlations between the global patient satisfaction score and all FAOS subscale scores were identified. Only 3 participants (4%) reported a complication following surgery; however, 32 participants (44.4%) indicated that they still experienced swelling and/or tenderness in their foot at the time of the survey (mean follow-up time 4.8 ± 2.8 years) but for the majority of patients this was improved from before surgery. Conclusion: Long-term patient satisfaction was experienced by the majority of patients following plantar fasciotomy. Although 44% of patients continue to have postoperative complaints, 73% indicated that they were satisfied with their symptoms postoperatively, and 74% would undergo a similar procedure again. Level of Evidence: Level IV, case series.