The effect of plantar calcaneal spur excision on plantar fascia surgery outcomes

Abstract

Plantar heel pain is a prevalent condition affecting 10 % of the population, with plantar fasciitis being the most common cause. Plantar calcaneal spurs are frequently associated with plantar fasciitis, yet their role in the condition and surgical outcomes remains unclear. This study investigates the impact of plantar calcaneal spur excision on the outcomes of plantar fascia surgery, utilizing a radiofrequency microtenotomy and bone marrow aspiration technique. A retrospective review of 136 plantar fascia surgeries was conducted with 83 cases including plantar calcaneal spur excision. Demographic and operative factors were analyzed. Outcomes included time to weight-bearing in a boot and shoes, symptom resolution, and complications. Plantar calcaneal spur excision was associated with a statistically significant delay in symptom resolution (p = 0.006) and time to weight-bearing in shoes (p = 0.020). A statistically significant difference was observed regarding operative laterality, with right-sided surgeries demonstrating an increased time to symptom resolution (p = 0.007) and a higher retreatment rate (p = 0.017) compared to left-sided surgeries. There was no significant difference in complication rates or the need for retreatment between excision and non-excision groups. These findings highlight the need for careful consideration of plantar calcaneal spur excision in surgical planning for plantar fasciitis, with implications for patient education and management strategies.