Platelets rich plasma for treatment of chronic plantar fasciitis

Abstract

Plantar fasciitis is a common cause of heel pain in adults. Many treatment options exist. Platelets rich plasma (PRP) is derived from autologous blood and contains high concentration of growth factors necessary for tissue healing. The use of PRP in the treatment of plantar fasciitis is a fairly recent and evolving concept. The purpose of our work was to study the effectiveness of PRP treatment for chronic plantar fasciitis. Between February 2010 and June 2011, 25 patients with chronic plantar fasciitis with a mean age of 44years were treated by PRP injection and included in this prospective study. All patients were assessed for the pain on Visual Analogue Scale (VAS) pre-injection and post-injection. Using ultrasound, the thickness of the plantar fascia was measured prior to the injection of PRP and at each visit of follow-up after injection. The mean follow-up was 10.3months. Using a visual analog pain scale, the average pre-injection pain in patients of was 9.1 (range 8-10). Prior to injection, 72% of patients had severe limitation of activities, and 28% of patients had moderate limitation of activities. Average post-injection pain decreased to 1.6. Twenty-two patients (88%) were completely satisfied, two patients (8%) were satisfied with reservations, and one patient (4%) was unsatisfied with using the visual analog scale. Fifteen patients (60%) had no functional limitations post-injection and eight patients (32%) had minimal functional limitations. Two patients (8%) had moderate functional limitations post-injection. Twenty PRP injections. Ultrasonography, we noted significant changes not only in thickness but also in the signal intensity of the plantar fascia after PRP injection. None of our patients experienced any complications from PRP injection at the end of follow-up period. Injection of PRP is safe and doesn't affect the biomechanical function of the foot. Our successful early findings with injection of PRP indicate that this may become a very commonly used modality in treating this difficult condition.