Comparative Prospective Study Between Platlete Rich Plasma and Steroid Injection in Treatment of Chronic Planter Fasciitis

Abstract

Purpose:Compare the results of injection of steroid and PRP in cases of chronic plantar fasciitis INTRODUCTION: plantar fasciitis can be a difficult condition to treat. results of platelet rich plasma (PRP) injection have been promising. We compared PRP to cortisone injection in the treatment of chronic plantar fasciitis resistant to conservative management. METHODS:38 heels (20 heels in the steroid group and 18heels in the PRP group)  with  plantar fasciitis  failed conservative treatment were included to receive either PRP or Steroid injection. All patients were assessed by Visual Analogue Score (VAS) for pain, at 2 weeks 1 month and 3months post injection . RESULTS:Our study included 38 patients; 20 in the steroid arm and 18 had PRP injections. The average age of the steroid injection group was 43.1±9.7 years and in the PRP was 43.1±8.4 years (P= 0.698). The starting average pain scores were 8.6 for both groups (P= 0.712). Then our patients were followed up clinically at 2 weeks, 1 month and 3 months following the injections. There was statistically significant lower VAS scores for the steroid injection group at all follow up visits (P< 0.001 in all follow ups). The average pain scores were 4.9 and 6.7 at 2 weeks follow up for the steroid injection versus the PRP respectively, it was 2 and 4.2 at 1 month and last 0.6 and 1.2 after 3 months respectively. CONCLUSIONS:PurposThe purpose of this study was to assess the safety and preliminary clinical results of platelet-rich plasma (PRP) injections for treating chronic plantar fasciitisMethods Fourteen consecutive patients with chronic plantar fasciitis receiving three injections of PRP into the plantar fascia were assessed 12 months after the procedure. The modified Roles and Maudsley score and a visual analogue scale (VAS) for pain were used to evaluate the clinical results. Results According to criteria of the Roles and Maudsley score, at 12 months of follow-up, results were rated as excellent in nine (64.3 %), good in two (14.3 %), acceptable in two (14.3 %) and poor in one (7.1 %) patient. VAS for pain was significantly decreased from 7.1 ± 1.1 before treatment to 1.9 ± 1.5 at the last follow-up (p < 0.01). Conclusions In this single-centre, uncontrolled, prospective, preliminary study, results indicate that treating chronic plantar fasciitis with PRP injections is safe and has the potential to reduce pain. This study demonstrates that both steroid and  PRP injections  are highly effective in treatment of chronic  plantar fasciitis but improvement in pain was more rapid with steroid injection. This study recommends for follow up for a longer period than three months to compare long term benefits of steroids and PRP.