A comparative prospective study of platelet rich plasma versus corticosteroid injection in chronic plantar fasciitis
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20231990Keywords:
AOFAS, Corticosteroid, Plantar fasciitis, Platelet rich plasmaAbstract
Background: The Plantar fasciitis is a common reason for heel pain which manifests as pain at medial process of calcaneal tuberosity. Patients are mostly diagnosed clinically on the basis of history. Conservative treatment in the form of stretching, non-steroidal anti-inflammatories, night splinting, ice packs, strapping, orthosis, and shoe modifications have been in use traditionally. Recently, the use of injectables like corticosteroids and platelet rich plasma (PRPs) has increased. This study aims at comparing the clinic-radiological outcomes of the two injectables in the treatment of chronic plantar fasciitis.
Methods: This was a Prospective, Comparative, Randomized, Hospital-based clinical case study conducted in the Department of Orthopaedics, Sawai Man Singh Medical College, Jaipur, Rajasthan. 60 patients of chronic plantar fasciitis were taken and divided randomly into group A (PRP) and group B (corticosteroids) and the results were assessed based on the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and the plantar fascia thickness.
Results: Mean VAS in Group A decreased from 8.07 before injection to 2.9 after injection and in Group B decreased from before 8.33 injection to 3.13 after injection, at the final follow-up. Mean AOFAS score improved from 54.06 to 90.60 and from 54.86 to 75.13 in the respective groups at the 6-months follow-up. Plantar fascia thickness (as measured using ultrasonography) decreased from 5.77 to 3.32 and from 5.6 to 3.73 in the respective groups. The improvements observed were statistically significant.
Conclusions: Local injection of platelet rich plasma is an effective treatment option for chronic plantar fasciitis when compared with steroid injection with long lasting beneficial effects.
References
Tu P, Bytomski JR. Diagnosis of heel pain. Am Fam Physician. 2011;84(8):909-16.
McMillan AM, Landorf KB, Gilheany MF, Bird AR, Morrow AD, Menz HB. Ultrasound guided corticosteroid injection for plantarfasciitis: Randomised controlled trial. BMJ. 2012;344:e3260.
Budiman-Mak E, Conrad KJ, Roach KE. The Foot Function Index: a measure of foot pain and disability. J Clin Epidemiol. 1991;44:561-70.
Gollwitzer H, Diehl P, von Korff A. Extracorporeal shock wave therapy for chronic painful heel syndrome: a prospective, double blind, randomized trial assessing the efficacy of a new electromagnetic shock wave device. J Foot Ankle Surg. 2007;46(5):348-57.
Wei LC, Lei GH, Sheng PY, Gao SG, Xu M, Jiang W. Efficacy of platelet-rich plasma combined with allograft bone in the management of displaced intra-articular calcaneal fractures: A prospective cohort study. J Orthopaedic Res. 2012;30(10):1570-6.
Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double- blind, randomized trial. Am J Sports Med. 2013;41(2):356-64.
Dragoo JL, Wasterlain AS, Braun HJ, Nead KT. Platelet-rich plasma as a treatment for patellar tendinopathy: a double-blind, randomized controlled trial. Am J Spor Med. 2014;42(3):610-8.
Eppley BL, Woodell JE, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: Implications for wound healing. Plast Reconstr Surg. 2004;114(6):1502-8.
Filardo G, Kon E, Della Villa S, Vincentelli F, Fornasari PM, Marcacci M. Use of platelet-rich plasma for the treatment of refractory jumper’s knee. Int Orthop. 2010;34:909-15.
Foster TE, Puskas BL, Mandelbaum BR. Platelet-rich plasma: from basic science to clinical applications. Am J Spor Med. 2009;37(11):2259-72.
Gosens T, Den Oudsten BL, Fievez E, van’t Spijker P, Fievez A. Pain and activity levels before and after platelet-rich plasma injection treatment of patellar tendinopathy: a prospective cohort study and the influence of previous treatments. Int Orthop. 2012;36:1941-6.
Hall MP, Band PA, Meislin RJ. Platelet-rich plasma: current concepts and application in sports medicine. J Am Acad Orthop Surg. 2009;17(10):602-8.
Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet- rich plasma. Am J Sports Med. 2006;34(11):1774-8.
Ferrari M, Zia S, Valbonesi M. A new technique for hemodilution, preparation of autologous platelet intraoperative blood salvage in cardiac surgery. Int J Artif Organs. 1987;10(1):47-50.
Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004;62(4):489-96.
Martinelli N, Marinozzi A, Carnì S, Trovato U, Bianchi A, Denaro V. Platelet-rich plasma injections for chronic plantar fasciitis. Int Orthop. 2013;37:839-42.
Singh D, Angel J, Bentley G, Trevino SG. Fortnightly review. Plantar fasciitis. BMJ. 1997;315(1701):172-5.
Beeson P. Plantar fasciopathy: revisiting the risk factors. Foot Ankle Surg. 2014;20(3):160-5.
Acevedo JI, Beskin JL. Complications of plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int. 1998;19(2):91-7.
Shetty VD, Dhillon M, Hegde C, Jagtap P, Shetty S. A study to compare the efficacy of corticosteroid therapy with platelet-rich plasma therapy in recalcitrant plantar fasciitis: a preliminary report. Foot Ank Surg. 2014;20(1):10-3.
Monto RR. Platelet-rich plasma efficacy versus corticosteroid injection treatment for chronic severe plantar fasciitis. Foot Ankle Int. 2014;35(4):313-8.
Reddy RM, Kumar AV, Shaik T, Rudra S. The role of PRP injection in the management of plantar fasciitis: The analytical prospective study in 60 patients. Nat J Clin Orthop. 2019;3(03):100-4.
Kukreja T, Agarwal T, Singh A, Bhugra H. Comparative study for the treatment of plantar fasciitis by corticosteroids versus platelet rich plasma. Med J DY Patil Univ. 2017;10:252-6.
Mahindra P, Yamin M, Selhi HS, Singla S, Soni A. Chronic plantar fasciitis: effect of platelet-rich plasma, corticosteroid, and placebo. Orthopedics. 2016;39(2):e285-9.
Tank G, Gupta R, Gupta G, Rohila R . Comparative study of platelet-rich plasma and corticosteroid injection in the treatment of plantar fasciitis. J Foot Ank Surg. 2017;4(2):84-9.
Shetty VD, Dhillon M, Hegde C, Jagtap P, Shetty S. A study to compare the efficacy of corticosteroid therapy with platelet-rich plasma therapy in recalcitrant plantar fasciitis: a preliminary report. Foot Ank Surg. 2014;20(1):10-3.
Sachdev T, Dwivedi A, Kumar A, Kushwaha N. Comparative analysis between platelet rich plasma and corticosteroid injection in plantar fasciitis. IJSR. 2018;7(11).
Reddy RM, Kumar AV, Shaik T, Rudra S. The role of PRP injection in the management of plantar fasciitis: The analytical prospective study in 60 patients. Nat J Clin Orthop. 2019;3(03):100-4.
Anandkumar P, Hussain LN. Comparative study of treatment of chronic plantar fasciitis using platelet rich plasma and local steroid injection. IJOS. 2019;5(3):196-9.