Minimally Invasive Ultrasound Guided Percutaneous Fasciotomy for the Treatment of Chronic Plantar Fasciitis

Category: Midfoot/Forefoot; Hindfoot Introduction/Purpose: Plantar fasciitis is one of the most common causes of foot pain among the United States’ population. There are several treatment options including both nonoperative and operative approaches. Recently, minimally invasive (MIS) percutaneous plantar fasciotomy has come on the market with anecdotally good patient outcomes but limited published literature. This study aimed to review the patient outcomes, complications, and revision rates in patients undergoing MIS ultrasound-guided percutaneous plantar fasciotomy for the treatment of chronic plantar fasciitis. Methods: A multicenter retrospective chart review of patients undergoing MIS ultrasound-guided percutaneous fasciotomy using the Tenex device (Trice Medical, Lake Forest California) from January 2020 to December 2022 was performed. The main data points collected were patient-reported outcomes, follow-up times, revision surgery, and complications. Continuous variables were defined as a mean and were compared using Paired Student’s T-Test. Multivariable linear regression analysis was utilized to determine specific factors that influenced outcomes when controlling for confounding variables. All P< 0.05 were considered significant. Results: There were 56 (42 female/14 male) patients that underwent 60 procedures. The average age and BMI were 48.6 years (range 19–80), and 33.2 kg/m 2 (range 19.7–58.6), respectively. There were two (3.3%) complications of wound-healing delays and one (1.7%) complication of nerve damage noted. There were two (3.3%) revisions. The average follow-up was 27 months (range 13.3–48.6). The average improvement in pain, physical function, and mobility Patient-Reported Outcomes Measurement Information System (PROMIS) scores were 5.2 (range: -5.1–25.8), P< 0.01), 3.6 (range -7–30.7, P=0.01), and 3.1 (range -6–25, P=0.01). Overall, over 90% of patients had no to minimal pain at the final follow-up. No specific demographic factors were significantly associated with an improvement in PROMIS scores or overall pain at final follow-up. Conclusion: MIS ultrasound-guided plantar fasciotomy appears to be a reliable surgical treatment option for chronic plantar fasciitis with high patient satisfaction, minimal complications, and low revision rates.