A comparative study between platelet-rich plasma, corticosteroid, and autologous whole blood injection in patient of plantar fasciitis

Abstract

Introduction: Majority of the patient with heel pain are diagnosed with plantar fasciitis (PF). PF is the condition characterized by isolated inferior heel pain particularly with the first steps of the day or after sitting for hours and the reason is due to degeneration of the plantar fascia and perifascial structures. Regular walking on hard surfaces, wearing hard sole footwear, and obesity are the risk factors for this condition. Injecting steroids is the most popular method of treating the condition but has its own advantages and disadvantages. There have been cases reported of rupture of plantar fascia after giving corticosteroid injections, especially when it was given repeatedly. Platelet-rich plasma (PRP) is known to enhance the healing process of the body as it has platelet-derived growth factors that boost the healing of soft tissue, bone healing, and also tendon healing. Aims and Objective: The objective of our study was to know among the PRP injection, autologous whole blood steroid injection which is a superior mode of intervention in PF management. Materials and Methods: A sample size of 225 was taken and patients were divided into 3 groups, in which Group A was given PRP injection, Group B was given steroid injection, and Group C was given whole blood. The follow-up was done on 2 weeks, 4 weeks, and 12 weeks. Patients of age more than 18, those who were clinically diagnosed PF, and those who were not improving with 3 months of conservative management were included in the study. Patients with any ligament injury or with Buerger’s disease, pseudo-gout, and Haglund disease were excluded from the study. All patients were asked for their pain to quantify it according to visual analog scale (VAS) scale and the score was noted on pre-injection follow by on 2 weeks, 4 weeks, and 12 weeks. Results: The VAS score before infiltration was almost similar (P > 0.05) in Group A (7.8 ± 1.26), Group B (7.5 ± 1.05), and Group C (7.8 ± 0.87). The VAS score significantly decreased in Group B who were injected steroids in the initial 2 weeks when compared to that of Group A who were injected PRP and Group C who were injected whole blood. A significant decrease in VAS was seen in Group A at after 12 weeks when compared to Group B and Group C. Conclusion: Our study showed that autologous PRP therapy can lead to a sustained reduction in symptom complaints when compared to corticosteroid injections and autologous whole blood. PRP injection holds promise as a potential therapy to hasten the healing of chronic PF.