Ultrasonic Fasciotomy for the Treatment of Chronic Plantar Fasciopathy: A Prospective Study.

OBJECTIVE: To evaluate the long-term efficacy and safety of an ultrasonic fasciotomy for plantar fasciopathy. DESIGN: Prospective observational study. SETTING: Tertiary care academic medical center. PARTICIPANTS: Patients with chronic plantar fasciopathy refractory to standard, conservative treatments were included in this study. INTERVENTIONS: Patients underwent ultrasonic fasciotomy of the plantar fascia. MAIN OUTCOME MEASURES: The primary outcome measures were change in visual analog scale at 12 and 52 weeks post-procedure compared with baseline as well as patients' self-reported satisfaction with the procedure. RESULTS: Sixty-seven patients were included. There was a significant improvement in visual analog scale at all follow-up time points, with an average overall improvement of 5.87 ( P < 0.0001). 94% of patients reported satisfaction with the outcomes of their procedure at 12 and 52 weeks. No procedural complications were seen. CONCLUSIONS: This study demonstrates that an ultrasonic fasciotomy is a safe and effective treatment option for chronic plantar fasciopathy, with continued symptom improvement and a high degree of patient satisfaction up to 52 weeks post-procedure. CLINICAL RELEVANCE: These findings suggest that an ultrasonic fasciotomy should be considered for patients with chronic plantar fasciopathy refractory to conservative treatments.

The content of secondary phenol metabolites in pruned leaves of Aloe arborescens, a comparison between two methods: leaf exudates and leaf water extract.

Aloe arborescens plants, originating from the deserts of South Africa, are grown in the Introduction Garden at Sede Boker in the Negev Desert of Israel. In previous studies, we developed agro-technical methods to raise the content of secondary phenol metabolites (SPhMs) in the Aloe leaves. Plants that are subjected to repeated leaf pruning respond by increasing the content of their SPhMs. The SPhMs found in Aloe arborescens include barbaloin, aloenin and derivatives of aloeresin. Such compounds are used for many purposes, including human skin protection from sun and fire burns and high radiation, as products of the pharmaceutics and cosmetics industries, and as food supplements for treating stomach ulcers and diabetes. In the current study, the SPhMs were separated from pruned leaves of the same A. arborescens plants at the same time by two methods: (1) exudation by squeezing the tissues of the leaves, (2) immersion of the leaves' pruned cut bottom in water and collection of the extract. The exudates and extract were frozen, freeze-dried to a powder and the SPhMs were then separated by chromatography. The yield of powder from water extraction from pruned leaves was much lower than the yield from the exudates. However, higher percentages of the powder from the water extraction contained SPhMs (between 80 and 92.7%). The content of powder in leaf exudates from pruned leaves was much higher because the SPhMs were squeezed out from the cells and tissues. However, the percentages of SPhMs in this powder were much lower (between 39 and 62%).