Background: Plantar fasciitis is a prevalent foot condition, often resolving without surgery. However, a subset of patients experiences persistent symptoms beyond 12 months, necessitating interventions like proximal medial gastrocnemius recession (PMGR). PMGR is hypothesized to alleviate plantar fasciitis by increasing ankle dorsiflexion. The procedure’s effects on gait remain unclear. Methods: A subgroup of 29 patients with chronic plantar fasciitis, treated with PMGR and stretching as part of the Plantar Fasciitis Cohort Study, was selected for this preoperative and 3-month postoperative 3-dimensional gait analysis (3DGA) study. Eligibility criteria included symptoms persisting for more than 12 months, failure of conservative treatments, and confirmed gastrocnemius tightness. Gait analysis was performed using a 3D motion capture system. The primary outcome was maximal ankle dorsiflexion during stance. Secondary outcomes included other kinematic, kinetic, and tempo-spatial gait variables potentially influenced by PMGR, the Gait Deviation Index (GDI), and passive ankle dorsiflexion. Results: Maximal ankle dorsiflexion during stance showed no significant change postoperatively (13.5 degrees 12.2, 14.9 vs 14.3 degrees 13.2, 15.3, P = .21). Secondary outcomes, including gait parameters and extremity-specific GDI scores, remained within normal ranges and showed no clinically significant changes. Passive ankle dorsiflexion increased significantly postoperatively, yet this did not translate to detectable changes in gait patterns. Patients demonstrated no notable gait deviations compared with a normative population pre- or postsurgery. Conclusion: Findings suggest that gait patterns are relatively robust and that increased joint range of motion does not appear to affect gait mechanics 3 months postoperative based on a single-segment foot model. Further studies are needed to investigate these findings and to explore the biomechanical mechanisms underlying symptom improvement. Level of Evidence: Level IV, exploratory prospective cohort study.
Riiser et al. (Wed,) studied this question.