More Iffy Research on an Iffy Procedure — Plantar Fasciotomy

A morphologic and functional analysis a year after the operation does not put our minds at ease

Smart Practice: The underlying operation here has all the hallmarks of a placebo intervention, and this study may be falsely reassuring. 

What’s the Claim?

A prospective, observational trial suggested that there were minimal morphologic and functional changes one year after endoscopic partial plantar fasciotomy for plantar fasciitis.

How’s It Stack Up?

The authors performed a number of measurements, some of them based on distances from a tantalum bead placed at the time of surgery. We’re not aware of other studies that have gone to such lengths to evaluate these endpoints, though we’re also not sure how accurate these measurements are. Tantalum beads are more commonly used for Roentgen stereogrammetric analysis (RSA), which is extraordinarily precise, but also calls for a much more involved experimental setup than was used here, involving multiple tantalum beads and two simultaneous radiographs (that’s what the “stereo” in the name means) in a calibration cage. We’re unsure whether one bead on a lateral radiograph with a 25-mm calibration sphere placed alongside the foot will be reliable for the purpose.

What’s Our Take?