Treatment Of Chronic Plantar Fasciitis Research Articles

PROSPECTIVE STUDY ON THE EFFECTIVENESS OF PLATELET-RICH PLASMA IN MANAGING CHRONIC PLANTAR FASCIITIS

Objectives: The objectives of this study were as follows: (1) Assess the impact of a single dose of platelet-rich plasma (PRP) injection on visual analog scale (VAS) scores for heel pain. (2) Evaluate the functional outcome scores following PRP treatment for chronic plantar fasciitis. (3) Measure and confirm the restoration of plantar fascia thickness through ultrasound (USG) assessments. (4) Determine the safety and viability of local PRP injection as a treatment option for individuals with chronic plantar fasciitis. Methods: This hospital-based prospective case series, spanning January 2019 to January 2020, enrolled 40 participants aged 25–65 with unilateral, persistent plantar fasciitis resistant to conservative treatment. Exclusion criteria included BMI ≥30, various pathologies, and recent injections. Ethical clearance was obtained, and participants received autologous PRP injections, with ultrasound measuring plantar fascia thickness. Post-injection, patients were monitored for adverse reactions, initiated stretching exercises, and progressed to weight-bearing activities after 6 weeks. Results: The study cohort, averaging 45 years (standard deviation [SD] 7.7), primarily comprised females with the right-foot prevalence. Symptom duration averaged 20 weeks (SD 4.5). Pre-injection VAS scores (6.7±1.2) significantly improved at 6 weeks (2.9±0.6) and 12 weeks (2.0±0.9) post-PRP injection (p<0.001). Plantar fascia thickness reduced from 5.1 mm (SD 0.6) to 4.1 mm (SD 0.5) at 12 weeks (p<0.001) and regular foot thickness: 3.7 mm (SD 0.5). Conclusion: The study reveals that a singular PRP injection brings about substantial and clinically meaningful enhancements in heel pain, functional outcomes, and the restoration of plantar fascia thickness, supported by ultrasound measurements. This underscores local PRP injection as a viable and safe therapeutic choice for those grappling with chronic plantar fasciitis.

Dose Escalation Can Enhance the Therapeutic Potential of Radial Extracorporeal Shock-Wave Therapy in the Treatment of Plantar Fasciitis in Runners.

Background and Objectives: Treatment of chronic plantar fasciitis is challenging given that there are various of available treatment options with no clear gold standard. The aim of the study was to examine the dose-escalation effect of rESWT on the biomechanical parameters of the plantar fascia and pain ailments. Materials and Methods: In the experimental group (n = 30), the intensity of the shock wave was increased every two subsequent treatment sessions. In the control group (n = 32), the treatment parameters were not changed. In both groups, six treatments were performed, with two treatment sessions a week. In order to assess the biomechanical parameters of the plantar fascia, myotonometric measurements were performed. The pain intensity was assessed using the Visual Analog Scale (VAS). Results: The tension of the plantar fascia attachment in the experimental group decreased from 27.69 ± 2.06 [Hz] before treatment to 26.29 ± 1.69 [Hz] after treatment (p = 0.009) and to 26.03 ± 2.15 [Hz] 1 month after the beginning of treatment (p = 0.003). In the control group, the frequency results did not change significantly (p > 0.05). Flexibility increased in both groups. The test results before treatment and 1 month after the beginning of the treatment showed statistical significance in the experimental group (p = 0.001) vs. (p = 0.002) in the control group. The differences were not statistically significant between groups (p > 0.05). The assessment of pain intensity carried out 1 month after the end of treatment in the experimental group amounted to 3.14 ± 2.28 points, which was statistically significantly lower compared to that in the control group, where it amounted to 5.14 ± 1.92 points. (p < 0.001). Conclusions: The use of rESWT performed with an increasing intensity of impact during subsequent treatment procedures demonstrated greater effectiveness in improving the biomechanical parameters of the plantar fascia and was also more effective in reducing the pain ailments. Our results are encouraging. The dose escalation in the treatment cycle is worth considering. To prove that this method of treatment is more effective, a randomized controlled trial should be carried out on a representative sample.

Effectiveness of corticosteroid injection vs platelet rich plasma (PRP) injection in the treatment of plantar fasciitis

Introduction: Plantar fasciitis is one of the most common causes for inferior heel pain in adults. Many noninvasive and invasive treatment modalities are available for its treatment. Local injection of corticosteroid and Platelet-rich plasma (PRP) is usually used in the treatment of chronic plantar fasciitis not responding to noninvasive conservative treatments. Objectives: To compare the efficacy of local injection of corticosteroids and platelet rich plasma (PRP) in the treatment of plantar fasciitis. Methodology: Patients diagnosed as plantar fasciitis and treated conservatively for at least 3 months and had no response to conservative treatment modalities were involved in this study and randomly allocated into 2 groups of 38 each (Group A and Group B). Patients were treated with local corticosteroid injection in group A and autologous PRP injection in group B. Clinical assessment was done prior to the injection and at 3 weeks and 3 months following the injection, which included visual analog pain scale (VAS), subjective rating using the modified Roles and Maudsley score (MRMS), functional outcome score by the Foot function Index (FFI). Results: The mean age, sex and body mass index was comparable for both groups. Postinjection, there was significant improvement (p &lt; 0.05) of visual analog score (VAS), modified Roles and Maudsley score (MRMS), Foot Function Index in both the groups. However, there was no significant difference (p &gt; 0.05) in improvement of VAS, MRMS and FFI when compared between the 2 groups. Conclusion: This study revealed that the treatment of plantar fasciitis with steroid or PRP injection was equally effective in patients who do not respond to conservative treatment.

Efficacy and Safety of Platelet-Rich Plasma Injection for Chronic Plantar Fasciitis: A Prospective Study on Functional Restoration and Pain Relief.

Background Heel discomfort and functional impairment are frequently caused by plantar fasciitis, and treating it can be extremely difficult for clinicians and occasionally have unfavorable clinical consequences. Recently, platelet-rich plasma (PRP) has been used as an alternative therapy for plantar fasciitis (PF) to reduce heel pain and improve functional restoration. We evaluated the current evidence concerning the efficacy and safety of PRP as a treatment for PF. Methodology This was a hospital-based prospective study on patients with plantar fasciitis with a symptom duration of six months or more with failed conservative therapy. All patients included in the study were assessed clinically and by a visual analog score (VAS) for heel pain, the Ankle-Hindfoot Scale (AHS) component of the American Orthopedic Foot and Ankle Society (AOFAS) and Foot and Ankle Ability Measure (FAAM) scores before injection, and at three weeks, three and six-months post-PRP treatment follow-up. Ultrasonography (USG) measurement of plantar fascia thickness was done pre-injection and at the six-month follow-up for clinical outcomes and any complications. Results The study included 25 patients with plantar fasciitis, with the majority (48%) in the age group of 21-30 years. Females accounted for 64% of the patientswhile males accounted for 36%. Most patients (56%) had a moderately active daily activity level. The study found that 16 patients had bilateral plantar fasciitiswhile nine had unilateral plantar fasciitis. Among the patients with bilateral plantar fasciitis, a total of 32 heels were affectedwhile the 9 patients with unilateral plantar fasciitis had 9 affected heels. Most female patients (75%) had bilateral plantar fasciitiswhile most male patients (56%) had unilateral plantar fasciitis. Before PRP therapy, both male and female patients reported high pain scores on theVASfor both heels. However, after PRP infiltration, the VAS scores significantly decreased at three weeks, three months, and six months post-injection, indicating pain relief. The AOFAS hindfoot and ankle scores and FAAM scores showed improvement over the follow-up period. Both male and female patients experienced significant improvements in functional outcomes, with increases in AOFAS (p-value 0.45) and FAAM scores (p-value 0.31) at three weeks, three months, and six months post-injection compared to baseline. Statistical analysis revealed a significant decrease in pain scores (73% pain relief), as well as significant improvements in AOFAS scores with an average of 22.33 from baseline (mean = 67.75±9.7) to final follow-up (mean = 90.08±7.9) and FAAM scores with an average of 23.72 from baseline (mean = 49.38±5.2) to final follow-up (mean = 73.10±5.2) after PRP infiltration. Conclusion The outcomes of a single dosage of PRP injections demonstrate clinically and statistically substantial improvements in functional outcome scores, plantar fascia thickness evaluated by USG, and VAS scores for heel pain. According to the results of this study, local PRP injection is an effective treatment for chronic plantar fasciitis.

A comparative analysis of functional outcome of local steroid and PRP in plantar fasciitis

Abstract Background: Plantar fasciitis is a common orthopedic issue that affects the quality of life. Various modalities of treatment have been tried for this condition, extending from conservative treatment to surgical treatment. Various studies have been conducted in different parts of the world to compare the results of local platelet-rich plasma (PRP) and steroids with varying results. Materials and Methods: We collected data at Mahatma Gandhi Medical College and Hospital, Jaipur, India with the approval of the IEC (Ethical Committee). From April 2016 to March 2017, 67 patients were included in the study through random sampling after obtaining written consent. Results: Plantar fasciitis was more common in the age group between 31 and 40 years. Plantar fasciitis was seen more commonly in females than males. Plantar fasciitis was seen more commonly in housewives and service providers. Both local steroid injection and autologous PRP injection are effective modes of treatment for chronic plantar fasciitis, but local steroid injection is effective for short-term pain relief, afterwards its effect gradually deteriorates, while autologous PRP injection provides better long-term pain relief. Patients were evaluated using the AOFAS score and the Visual Analogue Score, ranging from 0 to 10, at the onset of treatment, the 12-week follow-up, and the 24-week follow-up. An assessment was conducted in both categories. Conclusions: Both local steroid injection and autologous PRP injection are effective modes of treatment for chronic plantar fasciitis, but local steroid injection is effective for short-term pain relief (up to 12weeks as per our study), afterwards its effect gradually deteriorates, while the autologous PRP injection has better long-term pain relief.

Efficacy of Cushioned Insoles and Magnetic Insoles in the Treatment of Chronic Plantar Fasciitis

Efficacy of Cushioned Insoles and Magnetic Insoles in the Treatment of Chronic Plantar Fasciitis

Effects of local vibration combined with extracorporeal shock wave therapy in plantar fasciitis: a randomized controlled trial.

To compare the effects of local vibration combined with extracorporeal shock wave therapy and extracorporeal shock wave therapy alone for plantar fasciitis. A randomized controlled trial including 34 participants with a mean age of 37.5 years. Participants were randomly allocated to a group treated with extracorporeal shock wave therapy combined with local vibration (ESWT-LV group) or a group treated with extracorporeal shock wave therapy alone (ESWT-alone group). All participants in each group underwent 2 treatment sessions weekly for 5 weeks. Thickness of the plantar fascia, plantar pain, and foot function were measured using ultrasonography, numerical rating scale for pain, and Foot Function Index, respectively, at baseline and at the end of the 5-week intervention. Significant improvements were measured in both groups in the thickness of the plantar fascia, numerical rating scale, and Foot Function Index values (p < 0.05). In addition, the thickness of the plantar fascia and pain was significantly more decreased in the ESWT-LV group than in the ESWT-alone group (p < 0.05). However, the differences between groups in Foot Function Index values were not significant (p > 0.05). Local vibration combined with extracorporeal shock wave therapy is an effective treatment for chronic plantar fasciitis.

Autologous Whole-Blood Versus Corticosteroid Local Injection in Treatment of Plantar Fasciitis: A Randomized Single Blind Placebo-Controlled Study.

Autologous whole-blood intralesional injection has attracted interest as a possible means of treatment for chronic plantar fasciitis. We contrasted its effectiveness with that of corticosteroids, which have a longer history of success in treating tendinopathies such as plantar fasciitis. In order to monitor the disease's progress naturally, we also compared them with a placebo. Sixty clinically diagnosed patients were taken up for intralesional injection of autologous whole blood (AWB), corticosteroid, and normal saline as placebo mixed with 2 mL of lignocaine after dividing them into three groups. Two doses were given and followed up in the third, sixth, and 12th weeks. The evaluation was done according to the visual analog scale (VAS) and the number of tablets of paracetamol (PCM) 500 mg consumed for the following period. When compared to the placebo group in the third, sixth, and 12th weeks, the corticosteroid group exhibited a significant improvement with a p<0.001 in the VAS score, whereas the autologous whole blood group showed no meaningful difference. When compared to the placebo group at the sixth and 12th weeks, the AWB group's VAS score showed a statistically significant difference with a p>0.001. At each follow-up, the placebo group consumed more analgesics than the corticosteroid group, with a p<0.001. Only in the third week of follow-up did AWB demonstrate a statistically significant difference in PCM consumption as compared to the corticosteroid group. Statistically significant improvement was seen in both the AWB group and corticosteroid group as compared to the placebo group. The corticosteroid group achieved earlier and superior relief of pain while AWB had a longer lasting effect. Therefore, study results indicate almost similar results in short-term studies.

Comparison of autologous platelet-rich plasma and corticosteroid injection in the treatment of chronic plantar fasciitis

Chronic plantar fasciitis is one of the leading causes of heel pain and medical professionals can find it difficult to treat successfully over the long term. Due to any factor which increases tension on the medial calcaneal tuberosity insert (e.g., running, walking, prolonged standing, pes cavus, pes planus, overpronation), results in local inflammation. While the results of the use of platelet-rich plasma to treat chronic plantar fasciitis were encouraging, there is little documentation that compares the long-term effectiveness of chronic plantar fasciitis with steroid injection. It stimulates wound healing, bone healing, and tendon healing by releasing platelet-derived growth factors. This prospective randomized study is conducted to compare the efficacy of platelet-rich plasma and local injection of corticosteroid.

Endoscopic Plantar Fasciotomy as an Effective and Reliable Treatment for Plantar Fasciitis: An Overview of the Literature.

Plantar fasciitis is a common cause of heel pain. The aim of this study was to review the current literature and attempt to clarify whether endoscopic plantar fasciotomy (EPF) is an effective and reliable treatment for plantar fasciitis in comparison with other invasive or noninvasive treatments. We performed an electronic search of the medical literature in PubMed database using combinations of the following keywords: plantar fasciitis, endoscopic treatment, and plantar aponeurosis. Overall, we had shown that patients had better scores following EPF/endoscopic plantar fascia release. The clinical scores were improved postoperatively and most of the patients were satisfied. Furthermore, the clinical trials showed that time to return to work or to previous activities was shorter compared with other treatments. These studies suggest that EPF/endoscopic plantar fascia release is probably an effective treatment of chronic plantar fasciitis. EPF is an efficient, safe treatment with good early postoperative results in patients with recalcitrant plantar fasciitis. There is evidence that other methods are equivalently effective for EPF, and some authors support that they should be considered as a second-line treatment because of their minimal invasive character and very low risk of complications; thus, more research is required.

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

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.

Comparison of Extracorporeal Shockwave and High-Intensity Laser in Treating Chronic Plantar Fasciitis

Background: Plantar fasciitis (PF), an inflammation of the plantar fascia. This study compared the effects of the extracorporeal shockwave and high-intensity laser in reducing pain and enhancing function in chronic plantar fasciitis patients, who have failed to achieve results by the conservative treatment. Aim: To explore the best non-invasive treatment option for chronic PF within the scope of physical therapy. Method: After registry of trial the data collection was started.A total of45 chronic PF patientswere divided, randomly into three groups. Group 1 received BTL-6000 Shockwave therapy (ESWT) , group 2 received Diowave 60W Class IV hot Laser (HILT) and group 3 (the control group) was not given any electrotherapy treatment. All groups were given some exercises for the home plan. The groups were assessed with the Visual Analogue scale (VAS) and foot functional index (FFI) at baseline, post-treatment, and follow-up of 2 months. Result: The mean age of participants was 39.66±10.05,38.06 ±12.64 and 37.40±13.18 for ESWT, HILT group and control groups respectively. There was significant difference in VAS and FFI score p=&lt;0.001 across the time. Pre-treatment and post-treatment scores were significantly different but post treatment and follow-up scores were not significantly different for both VAS and FFI score (p=1.00). Practical implication: This study will help us to find out chronic Plantar fasciitis treatment within physical therapy and electrotherapy domain. As both these modalities are non-invasive, cost effective and proved as effective treatment for reduction of pain and improvement of pain in chronic plantar fasciitis patients. Conclusion: Extracorporeal shockwave have been promising treatment for chronic plantar fasciitis but High intensity LASER therapy effectiveness was not explored a lot in previous literature. The study concluded that both ESWT and HILT are effective in reducing pain and improving function on VAS and FFI, though the ESWT group was found better than both groups in FFI score and VAS across time on the basis of the mean differences across time. Keywords: Exercise, Extra-corporeal shockwave therapy, heel pain, High-intensity Laser therapy, Plantar fasciitis

A comparative study to analyze the efficacy of platelet rich plasma versus corticosteroids in treatment of chronic plantar fasciitis

Plantar Fasciitis is responsible for 15% of all foot problems. Over ten percent of the population will be affected at some point in their lives. It is caused by inflammation of a broad band of tissue that links your heel bone to your toes and runs across the bottom of your foot (plantar fascia). Plantar fasciitis is a type of plantar fasciitis that causes stabbing pain when you take your first steps in the morning. The discomfort usually goes away as you get up and move around, but it may come back after long periods of standing or when you stand up after sitting. Runners are more likely to get plantar fasciitis. The plantar fascia is made up of of white-coloured fibers that run longitudinally from the calcaneum to the toes. The attachments include the following: Proximal- Affixed to the calcaneum's medial tubercle. The fascia fanning out into five slips against the metatarsophalangeal joints and attaches to the base of the appropriate toes' proximal phalanges. Chronic heel pain is a difficult condition to treat and takes a long time to resolve. This study outlines both PRP and steroid are effective and safe modalities in the treatment of plantar fasciitis. But statistical data suggest that steroid injection is effective for immediate pain relief. And PRP injection is better for long term pain relief in plantar fasciitis with no side effects.

Prospective Comparative Short-Term Study of Autologous Leucocyte-Rich Platelet-Rich Plasma vs. Local Steroids in Chronic Plantar Fascitis

Background Plantar fasciitis is the most common cause of heel pain and is difficult to treat in most chronic and severe forms. Management of plantar fasciitis includes non-surgical options such as non-steroidal anti-inflammatory drugs and corticosteroids, physical therapy, orthotics, and surgical management includes plantar fasciotomy. Local injection of platelet-rich plasma as well as local steroids is an emerging concept in treating recalcitrant tendon and ligament pathology, including plantar fasciitis. Objectives The aim of the study was to evaluate and compare the outcome of patients treated with a single injection of autologous leucocyte-rich platelet-rich plasma with single-injection local steroids triamcinolone in chronic plantar fasciitis. Methodology The study was conducted for a duration of 24 months. In total, 60 patients with clinically diagnosed chronic plantar fasciitis were selected for study and divided in two groups using the single allocation randomization method as those treated with autologous injection leucocyte-rich platelet-rich plasma and those with injection local steroid triamcinolone and prospectively followed and compared. Results Both groups were evaluated subjectively and functionally at primary visit and then on follow-up at 2 weeks, 4 weeks, 8 weeks, and 12 weeks by VAS and hind foot AOFAS score. Conclusion We concluded that both injection platelet-rich plasma-treated and injection local steroid-treated patients provide symptomatic relief in the treatment of chronic plantar fasciitis both subjectively and functionally. The steroid treated group showed early symptomatic improvement at 2 weeks, and results at 12 weeks to further follow-up were suggestive that single-injection leucocyte-rich platelet-rich plasma provided better functional results.

To compare the efficacy of platelet-rich plasma with low-level laser therapy and low-level laser therapy alone in the treatment of chronic plantar fasciitis

To compare the efficacy of platelet-rich plasma with low-level laser therapy and low-level laser therapy alone in the treatment of chronic plantar fasciitis

Comparison of Platelet-Rich Plasma Treatment and Partial Plantar Fasciotomy Surgery in Patients with Chronic Plantar Fasciitis: A Randomized, Prospective Study

Platelet-Rich Plasma (PRP) injection has become a desirable alternative to Partial Plantar Fasciotomy (PPF) surgery and steroid injection for patients with chronic plantar fasciitis (CPF) due to its potential for shorter recovery times, reduced complications, and similar activity scores. As such, we compared PRP treatment to PPF surgery in patients with CPF. Between January 2015 and January 2017, patients were randomly divided into two groups, a PRP treatment group, and a PPF group. All procedures were performed by a single foot and ankle fellowship-trained specialist surgeon. Visual Analog Score (VAS) and Roles-Maudsley Scale (RM) were collected during the preoperative visit and 3, 6, and 12 months postoperatively. The patients were also closely followed by a physiotherapist. There were 16 patients in each group after four patients refused to participate. Patients in the PPF had low Roles-Maudsley Scale (RM) scores compared to the PRP group one-year after treatment (3.77 vs. 2.72, p < 0.0001). Both procedures showed a reduction in RM scores during the follow-up year (9 to 1.62 for PPF and 8.7 to 2.4 for PRP). There was no significant change in VAS pain between the two groups (p = 0.366). Patients treated with PRP injection reported a significant increase in their activity scores, shorter recovery time, and lower complication rates compared to PPF treatment. Moreover, with respect to existing literature, PRP may be as efficient as steroid injection with lower complication rates, including response to physical therapy. Therefore, PRP treatment may be a viable option before surgery as an earlier line treatment for CPF. Level of Clinical Evidence: II.

THERAPEUTIC EFFECT OF COCKTAIL VS PROLOTHERAPY INJECTION IN CHRONIC PLANTAR FASCIITIS, A PROSPECTIVE CONTROLLED RANDOMIZED CLINICAL STUDY

Introduction:- Plantar fasciitis is the most common cause of heel pain. It is a self-limiting condition. If causative factors are not addressed properly, it becomes chronic plantar fasciitis. Objectives:- The study aimed to evaluate the efficacy of 15 % hypertonic dextrose (treatment group) in the treatment of chronic plantar fasciitis through comparison with a cocktail group (control group). Design:- In this prospective controlled, randomized clinical study at N.S.C.B. Medical College Jabalpur, from 1 January 2020 to 31 September 2021. The statistical test used in this study isthe chi-square test and independent students t-test.A totalof 41 patients were taken intothe study. Patients were divided into two groups, In the Prolotherapy group (treating group) (n=18), a single shot of 15% Hypertonic dextrose injection was administered (1.2 ml of 50 % hypertonic dextrose, 1.8 ml distilled water and 1 ml of 2% lignocaine mixture)and the cocktail group (control group) (n=23) single shot of cocktail was given (1ml 40mg local methylprednisolone mixed with 1 ml distilled water and with 1 ml 2% lignocaine). During a 24-week follow-up period, pain intensity was measured using the visual analoguescale and American orthopaedics foot and ankle score, the measurements were undertaken before treatment and post-treatment weeks 4 and 12 and 24. Result:- In this study, both treatments were significantly effective in plantar fasciitis treatment for up to the 12th week. However the cocktail group (control group) was found to have a significantly better result at both the 4th week (AOFAS 93.17±3.33, VAS 1.65±.49 vs AOFAS 71.94±5.46, VAS 4.54±.71) and 12th week (AOFAS 90.43±2.86, VAS 1.91±.29 vs AOFAS 76.78±4.12, VAS 3.94±.64), but significantly better even up to 24th weeks (AOFAS 86.39±4.20, VAS 2.35±.71vs AOFAS 67.22±4.19, VAS 5.00±.34), (p-value &lt;.001) in term of pain intensity and disability as compared to prolotherapy group (treating group). Conclusion:- This study showed a favourable outcome towards the cocktail injectionin terms of VAS and AOFAS score as compared to prolotherapy injection.

Chronic Plantar Fasciitis: Comparison of Ultrasonic Guided Percutaneous Fasciotomy vs New Technique Combining Fasciotomy with Amniotic Membrane Allograft

Category: Basic Sciences/Biologics Introduction/Purpose: Plantar fasciitis is a common condition affecting approximately one in ten people in their lifetime. Treatment is typically conservative and symptoms are self-limiting. Operative treatment is indicated in recalcitrant cases. Minimally-invasive partial plantar fasciotomy can be performed using ultrasound-guided percutaneous techniques and is an attractive alternative to traditional surgery. Methods: A retrospective review was performed on consecutive patients who underwent either an ultrasound-guided fasciotomy or a combined percutaneous fasciotomy with a flowable amniotic matrix allograft. All ultrasound-guided percutaneous fasciotomy procedures were performed using the Tenex TX2 cutting device. Human amniotic allograft consisted of an injection of 0.5 mL of a flowable placental tissue matrix. Outcomes were assessed at short-term (2, 8, and 16 weeks) and long-term follow-up (26 and 52 weeks). Results: Both groups demonstrated a significant reduction in pain from baseline after the respective interventions and demonstrated a high level of patient satisfaction. The only significant difference in the 2 groups was at short-term follow-up in which the percutaneous fasciotomy with the amniotic membrane allograft (n=12) showed a statistically-significant reduction (p&lt;0.05) in pain when compared to the fasciotomy alone group (n=11). There was no difference between the 2 groups at long- term follow-up. Conclusion: Treatment of chronic plantar fasciitis using ultrasound-guided fasciotomy is an attractive alternative to traditional surgery. Ultrasound-guided fasciotomy did improve pain from baseline with high level of patient satisfaction. Furthermore, the combination of percutaneous fasciotomy with a flowable amniotic matrix allograft may provide a greater reduction in pain earlier in the post-operative period, but does not seem to alter the long-term outcome of the procedure. More subjects are needed to possibly detect long-term effects.

Treatment of chronic plantar fasciitis: a comparative study between shockwave therapies and local corticosteroid injection

Introduction One of the most prevalent ailments for which people seek treatment at a foot and ankle surgery facility is heel discomfort. Plantar fasciitis (PF) is one of the most common causes of adult heel pain and accounts for 11 to 15 % of all foot illnesses requiring medical care. The major symptom is pain and soreness at the heel where the plantar fascia is attached while starting weight- bearing after lengthy periods of rest. Rest, non-steroidal anti-inflammatory drugs (NSAIDs), stretching of the plantar fascia, physical therapy, foot cushioning, and orthotic devices, which may be utilized to meet the patient's demands, are some of the current conservative therapies for PF(planter fasciitis). In intractable instances of plantar fasciitis, where conservative therapy have failed to provide relief, steroid injections into the plantar fascia are often employed. Other treatment options for PF, including extracorporeal shockwave therapy (ESWT) are advised if patients do not react to conservative therapies. Patients and methods This study included 50 patients with chronic PF who had failed to react to conservative treatments such as physical therapy, NSAIDs, stretching exercises, and heel cushions for at least 6 months, and who did not have flatfeet or gastrocnemius contracture met the inclusion criteria. Patients were randomly divided into 2 groups: 25 patients received radial extracorporeal shockwave therapy (ESWT) once a week for six weeks (Group I); 25 patients got a single local corticosteroid injection at the plantar fascia's origin (40 mg / 2 ml of methylprednisolone together with 1 ml of local anesthesia, once) (Group II). Assessment of heel pain was done at the start of the trial and before each session using VAS score which was the primary outcome measure at 1, 3 and 6 months. Results A total of 50 individuals with persistent planter fasciitis (PF) were included in this investigation. Their age varied from 25 to 45 years old. Females made up 70 % of the sample, while males made up 30 %. Group I: 25 patients with PF who got extracorporeal shockwave treatment for 6 weeks at a time (once a week). There were 17 females (68 %) and 8 males (32 %), in the age ranging from 28 to 44 (mean SD 18.2).Group II: consisted of 25 individuals with PF who were given a local corticosteroid injection. There were 18 females (86.7 percent) and 7 males (13.3 percent) with ages ranging from 25 to 45 years (mean SD 21.9). Group I included 20 patients (80 %) and group II had 22 patients (88 %) who had pain in one foot, whereas 5 (20 %) patients and 3 (12 %) patients had pain in both feet, with no statistically significant difference. There was no significant difference between the groups in terms of the VAS score at the start of the trial (p = 0.26), the mean VAS scores were 6.4 and 6.2 in groups I and II, respectively. At one month, the mean VAS scores were 1.6 and 1.2 in group I and II, respectively. At 3 months, the mean VAS score were 2.2 and 1.7, at 6 months 5.1 and 2.3 for groups I and II, respectively. Conclusion ESWT and local corticosteroid injection therapies are safe and effective but local corticosteroid injection is more effective than ESWT in the treatment of chronic plantar fasciitis.

Effectiveness of dextrose prolotherapy for the treatment of chronic plantar fasciitis: A systematic review and meta-analysis of randomized controlled trials.

To systematically investigate the efficacy and safety of dextrose prolotherapy for treating chronic plantar fasciitis. EMBASE, PubMed, Scopus, and Google Scholar (from inception to December 9, 2021). Comprehensive review of randomized controlled trials investigating dextrose prolotherapy for chronic plantar fasciitis was done. Two investigators independently screened the titles, abstracts, and full texts and extracted data from eligible studies. The changes in visual analog scale (VAS) pain score, foot function index (FFI), American Orthopaedic Foot and Ankle Society (AOFAS) score, and plantar fascia thickness were analyzed. Reports of complications of the procedure were collected. Eight randomized controlled trials (RCTs) were included in the meta-analysis, analyzing 444 patients in total. The subgroup analysis showed that at short-term follow-up (<6months) dextrose prolotherapy was more effective in reducing VAS pain score compared to the non-active treatment control group including exercise and normal saline solution (NSS) injection. However, there was no difference in the change of VAS pain score between dextrose prolotherapy and active treatment control group, which included extracorporeal shock wave therapy (ESWT), steroid injection, and platelet-rich plasma (PRP) injection. Dextrose prolotherapy was more effective in reducing FFI, increasing AOFAS score, and reducing plantar fascia thickness at short-term (<6months) follow-up compared to other comparators. For long-term (≥6months) follow-up, there was no significant difference in the change in VAS pain score and FFI between the dextrose prolotherapy group and other comparators. No serious complication was reported. Dextrose prolotherapy is an effective treatment of chronic plantar fasciitis to reduce pain, improve foot functional score, and decrease plantar fascia thickness at short-term follow-up. Further studies in larger populations are needed to identify the optimal treatment regimen including dextrose concentration, volume, injection site, injection technique, and the number of injections required. The long-term effects of these treatments also require further examination.