With the year getting close to the end, I’m seeing more people who have met their deductible, and are inquiring about surgery for their long-standing plantar fasciitis. Over the years, I have tried different surgical procedures, and have varied my postoperative management, but within the last 2-3 years, I have found the procedure which has changed my practice. Firstly, I don’t perform an abundance of this type of procedure because I have a high success rate with my orthotics.
It’s important to understand that plantar fasciitis is really the wrong way to name this condition. Research has found that after a certain point in time, the condition is no longer inflammatory, but degenerative. The term “plantar fasciosis” is more appropriate. When the plantar fascia has become degenerative, there is a lack of circulation to the ligament at the insertion, and continued cortisone injections and anti-inflammatories are a waste of time.
I have been performing a procedure, Topaz, which is a tremendous option to open surgery. It works via coblation, thus increasing circulation to the ligament. It’s performed by multiple puncture holes through the skin, which you place a wand tip through and make multiple perforations in the ligament. This stimulates an inflammatory reaction and increases the circulation to the degenerative ligament. There is no incision, and bleeding is minimal. Better yet, patients remove a padded dressing the next day, can walk, and wear a surgical shoe for a week prior to returning to regular shoegear. I have been so pleased with this procedure, and if there is a failure, an open procedure can be performed.
So before undergoing “the knife,” ask if your surgeon does the Topaz surgery.