POSTER ABSTRACTS - ISAKOS

E-poster w/ Standard #122
Results of Endoscopic Plantar Facia Release
Rajesh Bazaz, Van Nuys, CA, USA, Presenter
Richard D Ferkel, Van Nuys, CA USA
Southern California Orthopedic Institute, Van
Nuys, CA, USA
Introduction:
Heel pain secondary to plantar fascitis is one of
the most common conditions seen by orthopedic
surgeons. A minority of patients require surgical
treatment. In the past an open procedure had
been performed, but more recently endoscopic
plantar fascia release (EPFR) has been advocated.
This study reviews our results with EPFR and
compares the outcome in workers compensation
(WC) and non-WC populations.
Methods:
Between 1995 and 2003, 20 patients (23 feet)
underwent partial medial EPFR. All patients
failed a conservative treatment program for at
least 6 months. Preoperative evaluations
including radiographs, EMG, and an inflammatory
lab panel were negative. The patients were
subdivided based on WC status. Group I (non-
WC) was composed of 11 patients (13 feet). There
were 9 females and 2 males. The average age was
47.9 years old (range 29-70). Group II (WC) was
composed of 9 patients (10 feet). There were 2
females and 7 males. The average age was 38.1
years old (range 28-48). Patients were evaluated
pre and post procedure using the AOFAS hindfoot
score and the Maryland foot score. Follow up at
an average of 44 months (range 12 to 107) was
available on 9 feet in Group I and 8 feet in Group
II.
Results:
Overall the AOFAS hindfoot score increased from
65.1 pre-operatively to 86.1 post-operatively. The
Maryland foot score increased from 61.1 preoperatively
to 80.7 post-operatively. The results
were also analyzed based on WC status.
Group I preoperative AOFAS hindfoot score was
66.8 and Maryland foot score was 53.8.
Postoperatively the scores were 91.7 and 89.9 (7
excellent, 1 good, 1 poor) respectively. Group II
preoperative AOFAS hindfoot score was 63.1 and
Maryland foot score was 55.1. Postoperatively the
scores were 79.9 and 70.4 (1 excellent, 2 good, 4
fair, 1 poor) respectively. There were no postoperative
infections or neurovascular injuries. No
patients noted lateral column pain and there was
no arch collapse.
Discussion:
Our results with EPFR at medium term follow-up
revealed a 21-point improvement in the AOFAS
hindfoot score and a 19.6-point improvement in
the Maryland foot score. On further analysis there
was a discrepancy in the results in the WC and
non-WC populations. Workers compensation
status has been shown to affect the outcome of
many surgical procedures. This is the first study
that evaluates the effect of WC status on the
outcome of EPFR. Group I and II were similar in
the severity of their plantar fascitis pre-procedure
based on the AOFAS hindfoot score and Maryland
foot score. Non-WC patients had greater
improvement in their AOFAS hindfoot score (24.9
points) compared to WC patients (16.8 points).
Non-WC patients also had a greater improvement
in their Maryland foot score (36.1 points)
compared to WC patients (15.3 points). Eight of
the nine non-WC were able to achieve good or
excellent results. Only 3 of 8 WC patients
experienced good or excellent results. Our data
suggests that the results of EPFR may be effected
by patient WC status.
E-poster w/ Standard #123
Results of Functional Postoperative Treatment
of Professional and Amateur Athletes After
Achilles Tendon Ruptures
Ewa Witek, Warszawa, POLAND, Presenter
Renata Jopek, Warszawa, POLAND
Aneta Jarzabek, Warszawa, POLAND
Carolina Medical Center, Warszawa, POLAND
PURPOSE:
To present postoperative rehabilitation
programme following Achilles tendon repair with
early weight bearing but without postoperative
full cast immobilisation and results of this
treatment
METHOD:
Sixty three one patients who were operated
between July 1998 and December 2003 in our
clinic: 25 patients were professional athletes
(basketball players, handball players,football
players, runners, boxers,.gymnasts), 17 were
amateur, 21participated only occasionally in
athletics activity.This group included 42 patient
with complete and 21 with partial rupturs.
Patient with total ruptures, were immobilised in
anterior splint in mild equinus position for 2
weeks after surgery. Following that period they
were allowed to begin partial weightbearing.
Patients could do full weightbearing after 6 weeks.
After 10-12 weeks they started running in