A comparative prospective study of platelet rich plasma versus corticosteroid injection in chronic plantar fasciitis

Abstract

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.