Clinical Outcomes of Percutaneous Plantar Fasciotomy in Patients with Refractory Plantar Fasciitis: a Retrospective Cohort Study.

Background: Plantar fasciitis is the most common cause of chronic heel pain. Accurate diagnosis is essential, as similar symptoms may arise from other conditions. Surgery is considered after six months of failed conservative treatment, with various techniques available. This retrospective study aimed to evaluate the outcomes of percutaneous plantar fascia release under local anesthesia in patients with plantar fasciitis. Methods: This retrospective study included adult patients diagnosed with plantar fasciitis - based on clinical and radiological evaluation - who underwent percutaneous plantar fascia release under local anesthesia between 2017 and 2020 in our Outpatient Orthopedic Clinic. Patients with previous foot surgeries, infections, tumours, systemic conditions (rheumatoid arthritis), or bilateral involvement were excluded. All had persistent symptoms for over six months despite conservative treatment. Data collected included demographics, symptom duration, body mass index (BMI), pain characteristics and functional limitations. Outcomes were assessed using the visual analog scale (VAS) and subjective patient satisfaction. Statistical analysis was performed using comparisons of means and the Chi-square test. Results: Twenty-three patients (15 women and eight men with a mean age of 50 years, range 39-78) underwent percutaneous plantar fascia release. The mean preoperative VAS score was 8.9 (range: 8-10) for pain, and 8.5 (range: 8-10) for daily activity limitation,. At six months postoperatively, the average VAS score decreased to 1.9 (range: 1-7) for pain and 1.6 (range: 1-6) for activity limitation, based on a telephone survey using the Benton-Weil questionnaire. Two patients (8.7%) reported persistent pain and dissatisfaction. The remaining 21 patients (91.3%) reported satisfactory outcomes. No correlation between spur size and outcomes was found. Statistical analysis showed a significant improvement in both pain and function (p < 0.05). Conclusions: Percutaneous plantar fasciotomy is a safe and effective treatment for plantar fasciitis. Further studies are needed to determine the optimal extent of fascial release and to refine patient selection criteria.