Is Gastrocnemius Recession Surgery best surgical treatment for Planter Fasciitis foot?

Heel discomfort that manifests in an outpatient situation is most frequently due to plantar fasciitis. It is deleterious, because it causes foot pain, ambulation problems, exercise restrictions, and the inability to support one's weight. Isolated gastrocnemius tightness has been found to be positively associated with the progression of plantar fasciitis and other foot-related pathological conditions. Around 10% of the patients with plantar fasciitis were reported to show no response to the conservative treatments like - rest, muscle-strengthening protocols, non-steroidal antiinflammatory stimulants, massage, heel pads, steroid, and platelet-rich plasma injections.

A systematic and meta-static review was conducted by Abhijit Bandyopadhyay et al to analyze the correlation between isolated gastrocnemius contracture and plantar fasciitis and the effectiveness of gastrocnemius recession surgery in the treatment of plantar fasciitis.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to conduct this meta-analysis. A literature search was carried out on the following databases, including Google Scholar, PubMed, EMBASE, and the Cochrane databases with the appropriate medical subject headings (MeSH) to identify the eligible articles.

Key findings of the study were:

• A total of 13 studies were included in this meta-analysis out of 721 articles.

• In this study, there is a significant difference in chronic plantar fasciitis outcome when comparing experimental and control (RR: 0.02; 95% CI: 0.01 to 0.05; P< 0.001)

• There is a significant difference in pain scale outcome when comparing pre-treatment and post-treatment (RR: 3.25; 95% CI 1.44 to 7.32; P=0.004< 0.01).

• A significant difference in VAS scale outcome when comparing pre-treatment and post-treatment (RR: 2.58; 95% CI 1.52 to 4.38; P=0.0004< 0.01).

“In conclusion, the current systematic review and meta-analysis of gastrocnemius recession and proximal medial gastrocnemius release and other treatment measures for plantar fasciitis suggests that the improvement of ankle dorsiflexion, reduction in pain, and patient satisfaction are almost similar in all the treatment measures. Among the five treatment measures, gastrocnemius recession remains the best, followed by proximal medial gastrocnemius release” the authors concluded. 

Further reading:

Isolated Gastrocnemius Contraction and Gastroc Recession Surgery in Case of Planter Fasciitis: A Systemic Review and Meta Analysis

Abhijit Bandyopadhyay et al

Indian Journal of Orthopaedics (2023) 57:1359–1375

https://doi.org/10.1007/s43465-023-00939-x