Comparative study between endoscopic plantar fascia release and proximal medial head gastrocnemius release in treatment of recalcitrant plantar fasciopathy: A pilot study

Objectives: Our study aimed to compare the clinical outcomes of endoscopic plantar fascia release (EPFR) and isolated proximal medial head gastrocnemius release (PMGR) for the treatment of patients with recalcitrant plantar fasciopathy. Methods: A prospective cohort pilot study was performed on 50 participants with recalcitrant plantar fasciopathy from January 2023 to May 2025. Two patient groups were formed: Group A (25 patients) underwent EPFR. Group B (25 patients) was treated by PMGR. Both groups were evaluated clinically and followed for 6 months. Results: All patients experienced satisfactory outcomes. The Visual Analog Scale at 6-month follow-up decreased from 8 to 3 in the EPFR group and from 8 to 4 in the PMGR group. Furthermore, the American Orthopaedic Foot and Ankle Society score increased from 26.84 ± 6.77 to 72.8 ± 17.95 in EPFR and from 26.52 ± 6.4 to 60.84 ± 22.76 in PMGR. Apart from one patient experiencing transient paresthesia, there were no significant complications. Conclusion: Both EPFR and PMGR were associated with significant pain reduction and functional improvement at 6 months in patients with recalcitrant plantar fasciopathy. PMGR showed greater improvement after 2 weeks, whereas EPFR was associated with lower pain scores at 6 months.