Plantar Fascia Surgery (Endoscopic)

What is Plantar Fascia Surgery (Endoscopic)?

Plantar Fascia Surgery (Endoscopic) also known as Endoscopic Plantar Fasciotomy (EPF), is a procedure used to remove a small portion of Plantar Fascia when the fascia becomes tightened or is contracted to cause inflammation and pain.

This surgery releases the tension and allows relief from inflammation. The outcome of this procedure is generally good with an overall 90% success rate.

What Conditions Does Plantar Fascia Surgery (Endoscopic) help?

Plantar Fascia Surgery (Endoscopic) helps in cases of chronic plantar fasciitis. It is required in about 5% of cases.

Why is Plantar Fascia Surgery (Endoscopic) Required?

This procedure is required when the inflammation and pain caused by the chronic plantar fasciitis is unresponsive to conservative treatment options, thus requiring surgical intervention to provide relief to the patient.

Who is Plantar Fascia Surgery (Endoscopic) Suitable for?

Plantar Fascia Surgery (Endoscopic) surgery is suitable for nearly all individuals.

However, people who are suffering from a lung or a heart condition or chronic disease such as diabetes are evaluated on a case by case basis before being considered eligible for this procedure.

Preparation Before Plantar Fascia Surgery (Endoscopic)

Plantar Fascia Surgery (Endoscopic) requires preoperative medical evaluation consisting of complete patient history and physical examination to determine suitability for the procedure, which may also include lab tests and X-Ray imaging.

In order to determine the best outcome, the individual should be adequately counselled to ensure that the informed consent obtained is fully understood.

The patient is also advised to stop using any anti-inflammatory medications (NSAIDs) at least seven days before the procedure.

Steps in Plantar Fascia Surgery (Endoscopic)

The Plantar Fascia Surgery (Endoscopic) can be performed under general anesthesia as well as light sedation as an out-patient procedure. The decision between the two is made by the operating surgeon.

The steps include:

• Making the individual comfortable,
• Identification of the proper limb and joint and surgical draping,
• Administration of general anesthesia or sedation and local anesthesia,
• Two small surgical incisions on either side of the heel,
• Insertion of a probe with a camera and a hook through the incisions,
• Cutting off a fascia portion with the hook using the images from the camera as a guide,
• Removal of the instruments,
• Closing the incision with stitches, and recovery from the anesthesia

The entire procedure can take 15 minutes to half an hour.

What Should I Expect after Plantar Fascia Surgery (Endoscopic)?

Immediately After Surgery

Immediately after the procedure, the patient is moved to the recovery room, where he is kept under observation until they regain consciousness where general anesthesia is used.

Pain medications are prescribed to help with pain during the recovery phase.

Discharge from Hospital

The patient is then discharged from the hospital in a day or two after the procedure.

The patient is advised on the steps to keep the wound dry and clean and on scar management. The patient is also advised to

• The patient is advised to maintain a strict elevation of the joint for ten days.
• arrange help to assist with chores, and
• avoid putting any weight on the joint, with the help of crutches and walkers.

Ten Days After Surgery

X-rays are repeated ten days after the procedure to determine the situation.

Physiotherapy

For the best possible outcome, postoperative physical therapy plays an important role in proper recovery following Haglund’s Bursa Removal. This postoperative management includes regular scheduled visits with a physical therapist.

Extended Recovery Period

The patient is advised to limit their activities for six to eight weeks after the surgery.

Certain activities such as driving are also restricted for up to six weeks post-surgery.



Possible Risk or Complications of Plantar Fascia Surgery (Endoscopic)

Plantar Fascia Surgery (Endoscopic) carries all the risks associated with surgery, such as infection, bleeding and a severe allergic reaction to anesthesia.

There is also a risk of nerve injury or chronic pain due to nerve entrapment and delayed healing.