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AOFAS Position Statements

Endoscopic and Open Heel Surgery

1. Nonsurgical treatment is recommended for a minimum of 6 months and preferably 12 months.
2. More than 90% of patients respond to nonsurgical treatment within 6 to10 months.
3. When surgery is considered in the remaining patients, then a medical evaluation should be considered prior to surgery.
4. Patients should be advised of complications and risks if an endoscopic or open procedure is not indicated.
5. If nerve compression is coexistent with fascial or bone pain, then an endoscopic or open procedure should not be attempted.
6. The AOFAS does not recommend surgical procedures before nonoperative methods have been utilized.
7. The AOFAS does support responsible, carefully planned surgical intervention when nonsurgical treatment fails and work-up is complete.
8. The AOFAS supports cost constraints in the treatment of heel pain when the outcome is not altered.
9. The AOFAS recommends heel padding, medications and stretching prior to prescribing custom orthoses, and extended physical therapy.
10. This position statement is intended as a guide to the orthopaedist and is not intended to dictate a treatment plan.