PROSPECTIVE STUDY ON THE EFFECTIVENESS OF PLATELET-RICH PLASMA IN MANAGING CHRONIC PLANTAR FASCIITIS
DOI:
https://doi.org/10.22159/ajpcr.2024.v17i5.50195Keywords:
Platelet-rich plasma, Chronic plantar fasciitis, Growth factorsAbstract
Objectives: The objectives of this study were as follows: (1) Assess the impact of a single dose of platelet-rich plasma (PRP) injection on visual analog scale (VAS) scores for heel pain. (2) Evaluate the functional outcome scores following PRP treatment for chronic plantar fasciitis. (3) Measure and confirm the restoration of plantar fascia thickness through ultrasound (USG) assessments. (4) Determine the safety and viability of local PRP injection as a treatment option for individuals with chronic plantar fasciitis.
Methods: This hospital-based prospective case series, spanning January 2019 to January 2020, enrolled 40 participants aged 25–65 with unilateral, persistent plantar fasciitis resistant to conservative treatment. Exclusion criteria included BMI ≥30, various pathologies, and recent injections. Ethical clearance was obtained, and participants received autologous PRP injections, with ultrasound measuring plantar fascia thickness. Post-injection, patients were monitored for adverse reactions, initiated stretching exercises, and progressed to weight-bearing activities after 6 weeks.
Results: The study cohort, averaging 45 years (standard deviation [SD] 7.7), primarily comprised females with the right-foot prevalence. Symptom duration averaged 20 weeks (SD 4.5). Pre-injection VAS scores (6.7±1.2) significantly improved at 6 weeks (2.9±0.6) and 12 weeks (2.0±0.9) post-PRP injection (p<0.001). Plantar fascia thickness reduced from 5.1 mm (SD 0.6) to 4.1 mm (SD 0.5) at 12 weeks (p<0.001) and regular foot thickness: 3.7 mm (SD 0.5).
Conclusion: The study reveals that a singular PRP injection brings about substantial and clinically meaningful enhancements in heel pain, functional outcomes, and the restoration of plantar fascia thickness, supported by ultrasound measurements. This underscores local PRP injection as a viable and safe therapeutic choice for those grappling with chronic plantar fasciitis.
Downloads
References
Nahin RL. Prevalence and pharmaceutical treatment of plantar fasciitis in United States adults. J Pain. 2018;19(8):885-96. doi: 10.1016/j. jpain.2018.03.003, PMID 29597082
Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002;36(2):95-101. doi: 10.1136/ bjsm.36.2.95, PMID 11916889
Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: A matched case-control study. J Bone Joint Surg Am. 2003;85(5):872-7. doi: 10.2106/00004623-200305000-00015, PMID 12728038
Rano JA, Fallat LM, Savoy-Moore RT. Correlation of heel pain with body mass index and other characteristics of heel pain. J Foot Ankle Surg. 2001;40(6):351-6. doi: 10.1016/s1067-2516(01)80002-8, PMID 11777230
Weiler A, Helling HJ, Kirch U, Zirbes TK, Rehm KE. Foreign-body reaction and the course of osteolysis after polyglycolide implants for fracture fixation: An experimental study in sheep. J Bone Joint Surg Br. 1996;78(3):369-76. doi: 10.1302/0301-620X.78B3.0780369, PMID 8636168
Gupta R, Malhotra A, Masih GD, Khanna T, Kaur H, Gupta P, et al. Comparing the role of different treatment modalities for plantar fasciitis: A double-blind randomized controlled trial. Indian J Orthop. 2020;54(1):31-7. doi: 10.1007/s43465-019-00038-w, PMID 32257015
Buccilli TA Jr., Hall HR, Solmen JD. Sterile abscess formation following a corticosteroid injection for the treatment of plantar fasciitis. J Foot Ankle Surg. 2005;44(6):466-8. doi: 10.1053/j.jfas.2005.07.020, PMID 16257677
Acevedo JI, Beskin JL. Complications of plantar fascia ruptureassociated with corticosteroid injection. Foot Ankle Int. 1998;19(2):91-7. doi: 10.1177/107110079801900207, PMID 9498581
Lee TG, Ahmad TS. Intralesional autologous blood injection compared to corticosteroid injection for treatment of chronic plantar fasciitis. A prospective, randomized, controlled trial. Foot Ankle Int. 2007;28(9):984-90. doi: 10.3113/FAI.2007.0984, PMID 17880872
Buchbinder R. Clinical practice. Plantar fasciitis. N Engl J Med. 2004;350(21):2159-66. doi: 10.1056/NEJMcp032745, PMID 15152061
Lemont H, Ammirati KM, Usen N. Plantar fasciitis: A degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003;93(3):234-7. doi: 10.7547/87507315-93-3-234, PMID 12756315
Cornwall MW, McPoil TG. Plantar fasciitis: Aetiology and treatment. J Orthop Sports Phys Ther. 1999;29(12):756-60. doi: 10.2519/ jospt.1999.29.12.756, PMID 10612073
Toomey EP. Plantar heel pain. Foot Ankle Clin. 2009;14(2):229-45. doi: 10.1016/j.fcl.2009.02.001, PMID 19501805
Genc H, Saracoglu M, Nacir B, Erdem HR, Kacar M. Long-term ultrasonographic follow-up of plantar fasciitis patients treated with steroid injection. Joint Bone Spine. 2005;72(1):61-5. doi: 10.1016/j. jbspin.2004.03.006, PMID 15681250
Kiter E, Celikbas E, Akkaya S, Demirkan F, Kiliç BA. Comparison of injection modalities in treating plantar heel pain: A randomized controlled trial. J Am Podiatr Med Assoc. 2006;96(4):293-6. doi: 10.7547/0960293, PMID 16868321
Molloy T, Wang Y, Murrell G. The roles of growth factors in tendon and ligament healing. Sports Med. 2003;33(5):381-94. doi: 10.2165/00007256-200333050-00004, PMID 12696985
Martinelli N, Marinozzi A, Carnì S, Trovato U, Bianchi A, Denaro V. Platelet-rich plasma injections for chronic plantar fasciitis. Int Orthop. 2013;37(5):839-42. doi: 10.1007/s00264-012-1741-0, PMID 23250352
Ragab EM, Othman AM. Platelets-rich plasma for treatment of chronic plantar fasciitis. Arch Orthop Trauma Surg. 2012;132(8):1065-70. doi: 10.1007/s00402-012-1505-8, PMID 22555761
Kumar V, Millar T, Murphy PN, Clough T. The treatment of intractable plantar fasciitis with platelet-rich plasma injection. Foot (Edinb). 2013;23(2-3):74-7. doi: 10.1016/j.foot.2013.06.002, PMID 23906977
Jain K, Murphy PN, Clough TM. Platelet-rich plasma versus corticosteroid injection for plantar fasciitis: A comparative study. Foot (Edinb). 2015;25(4):235-7. doi: 10.1016/j.foot.2015.08.006, PMID 26362235
Say F, Gürler D, İnkaya E, Bülbül M. Comparison of platelet-rich plasma and steroid injection in the treatment of plantar fasciitis. Acta Orthop Traumatol Turc. 2014;48(6):667-72. doi: 10.3944/ AOTT.2014.13.0142, PMID 25637732
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 Ankle Surg. 2014;20(1):10-3. doi: 10.1016/j.fas.2013.08.002, PMID 24480492
McMillan AM, Landorf KB, Barrett JT, Menz HB, Bird AR. Diagnostic imaging for chronic plantar heel pain: A systematic review and meta-analysis. J Foot Ankle Res. 2009;13(2):32. doi: 10.1186/1757-1146-2-32. PMID:19912628
Published
How to Cite
Issue
Section
Copyright (c) 2024 anusha k
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
