DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20200045

Study the efficacy of platelet rich plasma and local corticosteroid injection for treatment of chronic plantar fasciitis

Munin Borgohain, Raskin Phukon

Abstract


Background: Plantar fasciitis is one of the most common causes of heel pain. Various methods of treatment are available but no ideal treatment has been defined in literature. Corticosteroid (CS) injections are being used as a gold standard but studies have shown its short-term effects and various complications. Recently, platelet rich plasma (PRP) has been advocated as a newer treatment option. The main aim and objective of this study is to compare the two modalities of treatment regarding both pain and functional scores and their complications.

Methods: This study was a prospective cohort study. Total 90 patients with chronic plantar fasciitis visiting orthopaedic outpatient department of Assam Medical College and Hospital, Dibrugarh from July 2018 to June 2019 were enrolled for the study after clearance from Institutional Ethics Committee and equally divided into two groups. Group A received PRP and Group B received CS injections. They were assessed with visual analogue scale (VAS) and foot and ankle ability measure (FAAM) score at day 0, at 1 month, 3 months and 6 months. Level of significance was set at p<0.05.

Results: The score on VAS and FAAM improved from baseline for both the groups. CS showed better results at 1 month and 3 months but at 6 months, results of PRP were better. 3 patients had recurrences in CS group.

Conclusions: Corticosteroid injections provide immediate and short-term relief but PRP is beneficial with long term effects and without any complications.


Keywords


PRP, Corticosteroid injection, Plantar fasciitis, VAS score, FAAM score

Full Text:

PDF

References


Crawford F, Thomson CE. Interventions for treating plantar heel pain. Cochrane Database Syst Rev. 2003: 3.

Snider MP, Clancy WG, McBeath AA. Plantar fascia release for chronic plantar fasciitis in runners. Am J Sports Med. 1983;11(4):215–9.

Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003;93(3):234–7.

Davis PF, Severud E, Baxter DE. Painful heel syndrome: results of nonoperative treatment. Foot Ankle Int. 1994;15(10):531–5.

Young CC, Rutherford DS, Niedfeldt MW. Treatment of plantar fasciitis. Am Fam Physician. 2001;63(3):467–74.

Healey K, Chen K. Plantar fasciitis: current diagnostic modalities and treatments. Clin Podiatr Med Surg. 2010;27(3):369–80.

Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: a matched case-control study. JBJS. 2003;85(5):872–7.

Mohseni-Bandpei MA, Nakhaee M, Mousavi ME, Shakourirad A, Safari MR, Kashani RV. Application of ultrasound in the assessment of plantar fascia in patients with plantar fasciitis: a systematic review. Ultrasound Med Biol. 2014;40(8):1737–54.

Mushtaq N, Abbasian A, Cutts S, Obi N, Pasapula C, Chan W. Plantar fasciitis. Ann R Coll Surg Engl. 2013;95(3):229.

Dorotka R, Sabeti M, Jimenez-Boj E, Goll A, Schubert S, Trieb K. Location modalities for focused extracorporeal shock wave application in the treatment of chronic plantar fasciitis. Foot Ankle Int. 2006;27(11):943–7.

Hall MP, Band PA, Meislin RJ, Jazrawi LM, Cardone DA. Platelet-rich plasma: current concepts and application in sports medicine. Journal Am Acad Orthop Surg. 2009;17(10):602–8.

Ragab EMS, Othman AMA. Platelets rich plasma for treatment of chronic plantar fasciitis. Arch Orthop Trauma Surg. 2012;132(8):1065–70.

Barrett S, Erredge S. Growth factors for chronic plantar fasciitis. Pod today. 2004;17(11):37–42.

Sweeny J, Grossman BJ. Blood collection, storage and component preparation methods. Tech Manual 14th edition. Bethesda MD, Am Assoc Blood Banks; 2002: 955–8.

Dixon JS, Bird HA. Reproducibility along a 10 cm vertical visual analogue scale. Ann Rheum Dis. 1981;40(1):87–9.

Martin RL, Irrgang JJ, Burdett RG, Conti SF, Swearingen JM Van. Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int. 2005;26(11):968–83.

Yaratapalli SR, Nageswaran J, Chittaranjan S. Platelet rich plasma injection compared to corticosteroid injection in the treatment of chronic plantar fasciitis. IOSR J Dent Med Sci. 2015;14(9):44–9.

Acosta-Olivo C, Elizondo-Rodriguez J, Lopez-Cavazos R, Vilchez-Cavazos F, Simental-Mendia M, Mendoza-Lemus O. Plantar fasciitis—a comparison of treatment with intralesional steroids versus platelet-rich plasma: a randomized, blinded study. J Am Podiatr Med Assoc. 2017;107(6):490–6.

Ahmed GS, Shaikh AH, Tofique M. Local Steroid Injection For Treatment Of Planter Fasciitis. Comparison Between Methylprednisolone And Dexamethasone. Med Channel. 2013;19:4.

Thomas JL, Christensen JC, Kravitz SR, Mendicino RW, Schuberth JM, Vanore J V, et al. The diagnosis and treatment of heel pain: a clinical practice guideline–revision 2010. J Foot Ankle Surg. 2010;49(3):S1–19.

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.

Tatli YZ, Kapasi S. The real risks of steroid injection for plantar fasciitis, with a review of conservative therapies. Curr Rev Musculoskelet Med. 2009;2(1):3.

O’Malley MJ, Vosseller JT, Gu Y. Successful use of platelet-rich plasma for chronic plantar fasciitis. HSS Journal®. 2013;9(2):129–33.

Soomekh DJ. Current concepts for the use of platelet-rich plasma in the foot and ankle. Clin Podiatr Med Surg. 2011;28(1):155–70.

Mishra A, Woodall Jr J, Vieira A. Treatment of tendon and muscle using platelet-rich plasma. Clin Sports Med. 2009;28(1):113–25.

Sánchez M, Anitua E, Orive G, Mujika I, Andia I. Platelet-rich therapies in the treatment of orthopaedic sports injuries. Sport Med. 2009;35:1–10.

Lucarelli E, Beccheroni A, Donati D, Sangiorgi L, Cenacchi A, Del Vento AM, et al. Platelet-derived growth factors enhance proliferation of human stromal stem cells. Biomaterials. 2003;24(18):3095–100.

Kajikawa Y, Morihara T, Sakamoto H, Matsuda K, Oshima Y, Yoshida A, et al. Platelet‐rich plasma enhances the initial mobilization of circulation‐derived cells for tendon healing. J Cell Physiol. 2008;215(3):837–45.

Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT. Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost. 2004;91(01):4–15.

Alsousou J, Thompson M, Hulley P, Noble A, Willett K. The biology of platelet-rich plasma and its application in trauma and orthopaedic surgery: a review of the literature. J Bone Joint Surg Br. 2009;91(8):987–96.

Baksh N, Hannon CP, Murawski CD, Smyth NA, Kennedy JG. Platelet-rich plasma in tendon models: a systematic review of basic science literature. Arthrosc J Arthrosc Relat Surg. 2013;29(3):596–607.

Monto RR. Platelet rich plasma treatment for chronic Achilles tendinosis. Foot Ankle Int. 2012;33(5):379–85.

Virchenko O, Aspenberg P. How can one platelet injection after tendon injury lead to a stronger tendon after 4 weeks?: Interplay between early regeneration and mechanical stimulation. Acta Orthop. 2006;77(5):806–12.