Role of leukocyte free platelet rich plasma in planter fasciitis: a prospective study

Abstract

Background: Planter fasciitis, is by definition, inflammation of planter fascia. Most of the cases are well treated conservatively and a few responds to surgery only. Objectives of present study were evaluating the efficacy of a single injection of leukocyte free platelet rich plasma in plantar fasciitis and to derive a correlation between the clinical and radiological outcome.Methods: The present study consisted of 120 patients of bilateral (PF), (240 feet). These patients were divided into two groups PRP group of 60 patients and Placebo group of 60 patients. The study was conducted on patients attending Orthopaedics outpatient department Post Graduate Institute of Medial Education and Research (PGIMER) from July 2011 to June 2012. A primary efficacy criterion was changes from baseline in pain using (VAS). Functional results, level of satisfaction and outcome were measured by – AOFAS Foot Scale. Correlation of clinical with radiological outcome were performed.Results: There was a significant decrease in the visual analogue scale (pain score) in the PRP. Group while in placebo group it was increased significantly at the end of 6 month. Functional outcome scores were improved significantly from their baseline values in PRP group while in placebo group the mean functional score were deteriorated at 6 months follow up. There was no improvement seen in functional status with normal saline injection. In PRP group the mean heal pad thickness was reduced significantly at 6 months follow up while in placebo group was not changed significantly at 6 months follow up. Correlation between radiological parameters and VAS was found to be positive while it was found negative with other functional outcome scores like AOFAS.Conclusions: Platelet-rich plasma (PRP), which is a natural concentrate of autologous growth factors,plays a role in the regeneration process in treatment of (PF).

Platelet-Rich Plasma vs Extracorporeal Shock Wave Therapy in the Treatment of Plantar Fasciitis at 3-6 Months: A Systematic Review and Meta-analysis of Randomized Controlled Trials

“…Previous studies have demonstrated the clinical effectiveness of both PRP and ESWT in the management of PF. 2,9,12,16,21,31,32,40 However, our results show that PRP was superior in reducing pain outcomes when compared with ESWT. In fact, 6 of the 7 analyzed studies 6,11,13,27,33,38 showed better pain improvement in the PRP group, with the remaining study showing no significant differences between PRP and ESWT.…”

“…3,41 Previous studies present in the literature have reported the safety and efficacy of PRP in the treatment of recalcitrant PF, demonstrating its superiority when compared to placebo. 31,32 Extracorporeal shock wave therapy (ESWT) is another alternative noninvasive therapy option for tendon and musculoskeletal pathologies, including PF. Although the exact mechanism is not fully understood, it is postulated that use of pulsed acoustic sound waves contributes to the healing of degenerated or inflamed plantar fascia by stimulating neovascularization and collagen synthesis.…”

“…3,41 Previous studies present in the literature have reported the safety and efficacy of PRP in the treatment of recalcitrant PF, demonstrating its superiority when compared to placebo. 31,32…”

Platelet-Rich Plasma in Treatment of Plantar Fasciitis: Randomized Double-Blinded Placebo Controlled Study

“…These cells contain anti-inflammatory and pro-inflammatory cytokines that can affect the final outcome differently. While the former can help prevent infection [44,48], the latter may trigger local inflammatory reactions and enhance pain [42,49]. Accordingly, there seems to be no agreement on whether to use PRP low in leukocytes or not.…”