Plantar fasciitis: a comparison of ultrasound-guided fasciotomy with or without amniotic membrane allograft injection

Aim: The purpose of this study was to evaluate the clinical response to augmenting an ultrasound-guided percutaneous plantar fasciotomy (UGPF) with an amniotic membrane (AM) allograft injection. Design: Retrospective, single-center, matched, case-controlled study. Methods: Patients underwent either an UGPF (n = 15) or a combined UGPF and AM injection (n = 16). Results: The UGPF plus AM group demonstrated a significant reduction in pain (p = 0.02) from baseline at the short-term follow-up, but there was no significant difference in pain or patient satisfaction between groups at the 52-week follow-up. Conclusion: Both groups demonstrated a significant reduction in pain and high level of patient satisfaction, but the combination of UGPF with an AM injection may provide a greater reduction in pain earlier in the postoperative period. Plain language summary: The purpose of this study was to determine if a single injection of an amniotic membrane (AM) tissue injection improves pain and satisfaction scores for patients with chronic plantar fasciitis treated using ultrasound guided percutaneous fasciotomy (UGPF). The UGPF procedure involves using ultrasound to guide a cutting device into the plantar fascia to cut and remove degenerative tissue. 31 patients were included in the study (15 UGPF and 16 UGPF plus AM). Both groups demonstrated improvement in pain at the 16 and 52-week follow-up visits. There was a greater improvement in pain in patients treated with the UGPF and AM injection in the short term (at 16-week follow-up). There was no long-term difference between the two groups at the 52-week follow-up. Both groups demonstrated a high level of patient satisfaction. Findings suggest that combination of UGPF with AM tissue injection may improve symptoms of chronic plantar fasciitis sooner than if a patient only underwent an UGPF procedure alone. The AM allograft does not seem to change the long-term outcome. Larger studies are warranted. Tweetable abstract: In a preliminary study, researchers found that amniotic membrane injections may provide faster pain relief when injected into the plantar fasciotomy during surgery.