Does local steroid injection have a prognostic value for endoscopic plantar fascia release in chronic plantar fasciopathy?

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PURPOSE: To determine if previous local steroid injection can alter the patient response to endoscopic plantar fascia release. METHODS: It is a prospective non-randomized comparative study of 100 adult patients, suffered from plantar fasciopathy for at least one year, and had reported either temporary or no response to two or more of conservative treatments, including local corticosteroid injection. Enrolled patients were non-randomly allocated by convenience sampling into two groups. The first 50 patients who reported improvement in response to local corticosteroid injection were allocated to Group (A) The first 50 patients who did not report any improvement after injection were allocated to group (B) Both groups underwent endoscopic plantar fascia release. Clinical evaluation was carried out using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle-Hindfoot Scale (AOFAS) and Patient self-assessment (Roles and Maudsley score) preoperatively and at 4, 8 weeks, 3, 6, 12, and 24 months postoperatively. RESULTS: Both groups showed a statistically significant improvement in VAS for heel pain, AOFAS score, and Roles and Maudsley score. Group A demonstrated significantly better VAS, AOFAS, and self-assessment scores than group B at different follow-up intervals. Furthermore, trajectory analysis showed faster pain relief and functional recovery was observed in group A compared to group B. CONCLUSION: Patients who experienced temporary improvement after local corticosteroid injection had better clinical outcomes following endoscopic plantar fascia release. CLINICAL TRIAL NUMBER: Not applicable.

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