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Endoscopic gastrocnemius recession procedure using a single portal technique: a prospective study of fifty four consecutive patients

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Abstract

Background

Gastrocnemius recession has become a popular procedure to treat the equinus ankle caused by a tight gastrocnemius. The aim of our study was to prospectively evaluate the safety and efficacy of the endoscopic gastrocnemius recession procedure using a single portal technique.

Methods

The endoscopic gastrocnemius recession procedure was performed on 56 feet in 54 consecutive patients through a single lateral portal using the Smart Release Endoscopic Carpal Tunnel Release System. The minimum follow-up was 12 months. Functional outcomes were assessed with the Short Form 36 (SF-36), American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot score and modified Olerud and Molander (O&M) score. A modified Likert scale and visual analogue scores (VAS) were used to evaluate patient satisfaction and pain scores, respectively. Postoperative morbidities were documented for wound complications, scar hypersensitivity, sural nerve deficit and plantar flexion weakness. A p-value <0.05 was considered statistically significant.

Results

Endoscopic gastrocnemius recession procedure performed through a single lateral portal was successfully performed in all cases. Seven out of the eight component scores of the SF-36 questionnaire showed significant improvements. The AOFAS Hindfoot score showed a significant improvement of 20.69 ± 19.20. The modified O&M score also revealed significant improvements in eight out of nine component scores. There was a significant improvement of 3.79 ± 2.49 in VAS scores. A total of 91.07 % of all cases reported good or very good outcomes on the Likert scale. Eleven complications were recorded (three cases of unsatisfactory operative scar, three cases of sural nerve dysesthesia and five cases of subjective plantar flexion weakness with complete resolution in two out of the five patients.).

Conclusion

This study demonstrates that the endoscopic gastrocnemius recession procedure performed through a single portal technique has low morbidity with good to excellent results.

Level of Evidence

Level III, retrospective study.

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Acknowledgments

The authors would like to acknowledge Dr. Chong Keen Wai for his contribution in the development and education of this operative technique.

Funding

This project was not funded by any external source.

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Authors and Affiliations

  1. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Lee Bing Howe & Christopher Fang

  2. Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore, 308433, Singapore

    Gowreeson Thevendran & Kannan Kaliyaperumal

Authors
  1. Gowreeson Thevendran
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  2. Lee Bing Howe
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  3. Kannan Kaliyaperumal
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  4. Christopher Fang
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Correspondence to Gowreeson Thevendran.

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Thevendran, G., Howe, L.B., Kaliyaperumal, K. et al. Endoscopic gastrocnemius recession procedure using a single portal technique: a prospective study of fifty four consecutive patients. International Orthopaedics (SICOT) 39, 1099–1107 (2015). https://doi.org/10.1007/s00264-015-2723-9

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  • DOI: https://doi.org/10.1007/s00264-015-2723-9

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