Autologous whole blood or corticosteroid injections for the treatment of epicondylopathy and plantar fasciopathy? A systematic review and meta-analysis of randomized controlled trials

Tsikopoulos, Konstantinos; Tsikopoulos, Alexios; Natsis, Konstantinos

doi:10.1016/j.ptsp.2016.02.002

Cited by 25 publications

(50 citation statements)

References 46 publications

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“…There have been 2 published systematic review and meta-analysis of autologous whole blood or autologous blood-derived products (ABPs) for plantar fasciitis. [ 31 , 32 ] However, their results were different from the findings of the present meta-analysis. In the study conducted by Hsiao et al, [ 31 ] the authors compared the efficacy of ABPs, corticosteroids or shock-wave therapy in the treatment of plantar fasciitis.…”

Section: Discussioncontrasting

confidence: 99%

Effects of platelet-rich plasma in the treatment of plantar fasciitis

Ling¹,

Wang²

2018

Medicine

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Background:Plantar fasciitis is a common cause of heel pain, which often results in significant morbidity. There have been several treatment options that are used for plantar fasciitis, including nonsteroidal anti-inflammatory drugs, orthoses, physical therapy, and steroid injections.Objectives:The aim of this meta-analysis was to compare the effects of platelet-rich plasma (PRP) and other treatments in patients with plantar fasciitis.Search methods:Medline, Web of Science, and Embase were systematically searched to identify relevant trials.Selection criteria:Randomized controlled trials (RCTs) that compared the effects of PRP and other treatments on plantar fasciitis were included.Data collection and analysis:The main outcomes included changes from baseline in visual analog scale (VAS) score, American Orthopaedic Foot and Ankle Society Score (AOFAS), and Roles–Maudsley score (RMS). Results were expressed as weight mean difference (WMD) with 95% confidence interval (95% CI). The meta-analysis was performed using a fixed-effects or random-effects model according to heterogeneity.Main results:Ten RCTs involving a total of 445 patients with plantar fasciitis were included. Among these studies, 9 compared PRP with steroid, and 1 compared PRP with whole blood.Four studies were categorized as being at low risk of bias, and the remaining 6 as being at unclear risk of bias.Pooled estimates suggested that PRP had greater changes in VAS and AOFAS scores than other treatments. However, it had no benefit effect in the RMS.Subgroup analysis for VAS and AOFAS showed that PRP had superior effect than other treatments at 12 months, but not at the 1, 3, 6 months.Subgroup analysis based on treatment regimens demonstrated that PRP was more effective than steroid in the change from baseline in AOFAS, but not in VAS and RMS scores.Authors’ conclusion:PRP was as effective as other treatments in reducing pain and improving function in patients with plantar fasciitis. Subgroup analysis indicated that PRP had better effect than steroid in AOFAS Score and its effect was durable in a long term. However, considering the potential limitations in this study, more large-scale RCTs are needed to confirm the current findings.

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Section: Discussioncontrasting

confidence: 99%

Effects of platelet-rich plasma in the treatment of plantar fasciitis

Ling¹,

Wang²

2018

Medicine

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“…Tsikopoulos K, et al compared the efficacy of corticosteroid injections vs. autologous whole blood in plantar fasciopathy [13]. The primary outcome being studied was pain relief and secondary outcome was the evaluation of composite results.…”

Section: Discussionmentioning

confidence: 99%

Novel and Conservative Approaches Towards Effective Management of Plantar Fasciitis

Assad

Ahmad

Kiani

et al. 2016

Cureus

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We assessed the effectiveness of the different treatments for plantar fasciitis (PF) based on the changes in functional outcomes. A systematic literature search was carried out and studies from 2010 to 2016 were included in this review. The databases from Google Scholar, PubMed and Cochrane were used for the various treatment modalities of plantar fasciitis. The objectives measured included visual analog scale (VAS), Roles and Maudsley scale, foot function index (FFI), plantar fascia thickness and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot scale as the tools to predict the improvement in symptoms of pain and discomfort. Eight randomized controlled trails that met the selection criteria were included in this review. Extracorporeal shock wave lithotripsy (ESWL) with botulinum toxin type A, corticosteroid injections, autologous whole blood and plasma treatment, novel treatments like cryopreserved human amniotic membrane, effect of placebo, platelet rich plasma injections and corticosteroid injections, physiotherapy and high strength training were analyzed. All the treatment modalities applied did lead to the reduction in pain scores, but for long term management autologous condition plasma and platelet rich plasma are the preferred treatment options. Impact of physiotherapy and high strength training is equivalent to corticosteroid injections and hence is suited for patients avoiding invasive forms of treatment.

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“…[64][65][66] On the opposite, two recent meta-analysis of nine RCTs failed to confirm those data. 67 68 Tsikopoulos et al 67 showed that corticosteroid injections are more effective in pain relief in the short term, whereas Yang et al 68 ► Most common term referred to a cluster of products including: autologous conditioned plasma, platelet-enriched plasma, platelet-rich concentrate, autogenous platelet gel, platelet releasate, platelet rich in growth factors and others. ► Refined product of autologous blood with a platelet concentration greater than that of whole blood.…”

Section: Plantar Fasciitismentioning

confidence: 99%

Platelet-rich plasma in orthopaedic sports medicine: state of the art

Milano

Sánchez

et al. 2019

Journal of ISAKOS

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Platelet-rich plasma (PRP) is one of the many new developments within the expanding field of regenerative medicine. It aims to improve the process of tissue repair through local delivery of autologous bioactive agents to influence critical physiological mechanisms such as inflammation, angiogenesis or extracellular matrix synthesis. Within orthopaedics and sports medicine, the use of PRP has been rapidly increasing in popularity as patients seek non-surgical approaches to acute and chronic musculoskeletal injury and disease. The popularity of this new treatment option has prompted a rapid increase in research endeavours. Although preclinical studies were encouraging, clinical studies often reported controversial results. The differences in the composition and application techniques of PRP have made comparisons regarding its efficacy difficult and somehow inconclusive. Although PRP appears to be a safe treatment option with potentially beneficial effects to injured musculoskeletal tissues, continuous efforts are needed to identify factors that influence the biological response to PRP treatment. It is likely that in the near future the PRP preparation will be tailored not only to the specific pathology of interest but also to stage of disease. However, the growing emphasis on an evidence-based approach in the sports medicine setting demands additional research efforts before incorporating this technology in routine clinical care. The current review explores the latest findings on PRP efficacy in several musculoskeletal conditions, focusing on results of the highest level of evidence available.

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Autologous whole blood or corticosteroid injections for the treatment of epicondylopathy and plantar fasciopathy? A systematic review and meta-analysis of randomized controlled trials

Cited by 25 publications

References 46 publications

Effects of platelet-rich plasma in the treatment of plantar fasciitis

Effects of platelet-rich plasma in the treatment of plantar fasciitis

Novel and Conservative Approaches Towards Effective Management of Plantar Fasciitis

Platelet-rich plasma in orthopaedic sports medicine: state of the art

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