EPF post from a Dr.
Posted by scott on 2/28/99
I would like to share parts of an article written in the february, 1999 issue of the Journal of the American Podiatric Medical Association. It was co-authored by Paul A. Stone, D.P.M., one the pioneers of this procedure. The title of the article is Retrospective Review of Endoscopic Plantar Fasciotomy, 1994 Through 1997. In it he compared the results to a similar study from 1992 through 1994. In the new study he used 5 modifications of the EPF originally presented by Barret and Day. Most notably he only releases 50% of the plantar fascia and he uses a short leg walking cast for 4 to 6 weeks post-op. The mean duration of heel pain in the patients in the new study prior to surgery was 51.88 months. This is more evidence that exhaustive conservative theray must be tried before considering surgery. I think this web page eloquently describes appropriate conservative therapy. The second interesting point was mean time for pain to resolve after surgery was108.2 days and mean time to return to normal activities was 94.5 days. This is a clear indication that the EPF is not the "miracle" that it once was thought to be. Originally, Barret and Day advocated return to normal activities in three days. Finally, The patients in the study were asked if they would recommend the procedure to others. 92% answered YES. Would you undergo the procedure again? 84% answered yes. So in conclusion, if you have chronic plantar fascitis try exhaustive conservitive therapy first for even up to 4 years. If you are considering surgery, the endoscopic plantar fasciotomy is the way to go. Use a cast post-op and be patient, the pain will go away.
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