title: Endoscopic gastrocnemius recession procedure using a single portal technique: a prospective study of fifty four consecutive patients.
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.).
  
  
  CONCLUSIONS
  This study demonstrates that the endoscopic gastrocnemius recession procedure performed through a single portal technique has low morbidity with good to excellent results.
  
  
  METHODS
  Level III, retrospective study.
authors.affiliation: Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore, 308433, Singapore, xanthus23@hotmail.com.
authors.forename: Gowreeson
authors.initials: G
authors.lastname: Thevendran
authors.forename: Lee Bing
authors.initials: LB
authors.lastname: Howe
authors.forename: Kannan
authors.initials: K
authors.lastname: Kaliyaperumal
authors.forename: Christopher
authors.initials: C
authors.lastname: Fang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000601:surgery; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D004863:Equinus Deformity / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D010146:Pain / Q000601:surgery; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult