Summary

PRP injection is more effective in reducing thickened plantar fascia and symptoms than steroid injection,

Abstract

Background

/ OBJECTIVE: chronic Plantar fasciitis is characterized by pain in the heel, which aggravates on weight bearing after prolonged rest and thickened plantar fascia (>4mm). Many studies show that steroid injection provides pain relief in the short term, but relief is not long lasting. Recent literature shows autologous platelet-rich plasma (PRP) injection promotes healing, resulting in better pain relief as well as reduction in plantar fascia thickness. This study was undertaken to compare the effects of local injection of Platelet Rich Plasma and Corticosteroid in the treatment of chronic plantar fasciitis.

Methods

Patients with the clinical diagnosis of chronic plantar fasciitis after failed conservative treatment and plantar fascia thickness more than 4mm were included in the study. Patients with bilateral plantar fasciitis, vascular insufficiency or neuropathy, hypothyroidism and diabetics were excluded from the study.
In this prospective double-blind study 80 patients included were divided randomly into two groups. Patients in group-A received PRP injection and in group-B received steroid injection. Patients were assessed with visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) score. Assessment was done before injection, at 4 weeks, 3 months and at 6 months follow-up. Plantar fascia thickness was assessed before the intervention and six months after treatment.

Results

Mean VAS in group-A and group-B decreased from 7.3 and 7.41 before injection to 1.41 and 2.9 at final follow-up, respectively. Mean AOFAS score in group-A improved from 56 to 92.03 and in group-B improved from 55.6 to 76.67 at 6 months follow-up. The improvement observed in VAS and AOFAS was statistically significant. At the end of six months follow-up, plantar fascia thickness reduced in both groups (5.86mm to 3.35mm in group-A & 5.6 to 3.8 in group-B) and the difference was statistically significant.

Conclusions

Local injection of platelet-rich plasma is effective in reducing symptoms and plantar fascia thickness in chronic planter fasciitis.