Both local PRP and corticosteroid injections found effective for chronic plantar fasciitis
Patients with chronic plantar fasciitis can be effectively treated with local injection of platelet-rich plasma or corticosteroid, according to results.
In their double-blind study, Pankaj Mahindra, MS, and colleagues from Dayanand Medical College and Hospital, in Ludhiana, India, and Guru Gobind Singh Medical College and Hospital, in Faridkot, India, randomly assigned 75 patients with chronic plantar fasciitis to receive either platelet-rich plasma injection (PRP), corticosteroid injection or normal saline injection. All patients included in the study had not responded to 3 months of conservative therapy, and those who received NSAIDs as part of conservative therapy discontinued using these medications 1 week before injection.
The researchers assessed patients with VAS and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot scores prior to injection, at 3 weeks and at 3 months after injection. They compared the preinjection VAS and AOFAS scores to the scores at 3 weeks and 3 months after injection between the three groups of patients.
Results showed there was an improvement in the mean VAS score from 7.44 before injection to 3.76 at 3 weeks and 2.52 at 3 months following the injection in the PRP group. For the corticosteroid injection group, VAS scores improved from 7.72 to 2.84 at 3 weeks and to 3.64 at 3 months following injection. Similarly, investigators found the mean AOFAS score improved from 51.56 in the PRP group and 55.72 in the corticosteroid group before injection to 83.92 and 86.6 at 3 weeks, respectively, and to 88.24 and 81.32 at 3-month follow-up, respectively.
The results showed the saline injection group had a baseline mean VAS score of 7.56, which improved to 7.12 at 3 weeks and to 7.44 at 3 months after the injection. The baseline mean AOFAS score for the placebo group was 50.28. The score was 53.88 and 50.84 at 3 weeks and 3 months after the injection, respectively.
Although researchers noted significant improvement in the VAS and AOFAS scores in the PRP and corticosteroid groups at 3-week and 3-month follow-ups, they reported no significant improvement in the VAS or AOFAS scores for the control group at any time point.
The results also showed that compared with the corticosteroid group, the PRP group had a significantly higher AOFAS score at the 3-month follow-up; however, there was no significant difference in the VAS scores between these groups. – by Casey Tingle
Disclosure: The researchers reported no relevant financial disclosures.