Local Injection of Autologous Platelet Rich Plasma and Corticosteroid in Treatment of Plantar Fasciitis in Female Patients
Background: Chronic plantar fasciitis is the commonest cause of foot complaints in India. The incidence of plantar fasciitis peaks in people between the ages of 40 to 60 years with no bias towards either sex. Numerous methods have been advocated for treating plantar fasciitis, including rest, non-steroidal anti-inflammatory medication, night splints, foot orthosis, stretching protocols and extracorporeal shock wave therapy. The aim of this study to compared the functional outcome of Local Steroid and PRP in Plantar Fasciitis. Methods: A prospective randomized control trial done on 63 patients with complaint of plantar fasciitis coming to SMS Medical College & Hospitals, Jaipur, who were attain the inclusion criteria in the study. Patient coming to OPD were randomly allocated C.R. number. Patients with Odd C.R. number were given PRP and those with even number were given Steroids. Patients were followed at 12 weeks and 24 weeks after the injection to look for the effect of PRP and corticosteroid. Then the results were obtained on mean VAS score and AOFAS score in both the groups. Results: The present study showed that the mean age was 40 years in group I and 39 years in group II. Maximum females were housewife (41.26%) in both groups. The difference of mean in between groups, VAS score & AOFAS was insignificant in first visit (P=0.8642 & P=0.3400) and statistical significant after 12 weeks (P<0.0001*** each) and 24 weeks (P<0.0001***each). Conclusions: We believe that PRP injection is safe and can be an excellent alternative to corticosteroid injection in plantar fasciitis, not responsive to conservative means. The findings of this preliminary study can be very relevant in clinical practice.
2. Gill LH. Plantar fasciitis: Diagnosis and conservative treatment. J Am Acad Orthop Surg., 1997; 5: 109-117.
3. Taunton J, Ryan M, Clement D, McKenzie D, Lloyd-Smith D, Zumbo B. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med, 2002, 36: 95-101.
4. Buchbinder R. Clinical practice. Plantar fasciitis. N Engl J Med, 2004, 350: 2159-2166.
5. Woolf AD, Pfleyer B. Burdon of majormusculoskeletal conditions. Bull World Health Organ., 2003; 81: 646-56.
6. Crawford F, Thomson C.interventions;3:CD000416 .For treating plantar heel pain. Cochrane Database Syst Rev ,2003.
7. Cole C, Seto C, Gazewood J: Plantar fasciitis: evidence-based review of diagnosis and therapy. Am Fam Physician 2005, 72:2237-2242.
8. Acevedo J, Beskin J: Complications of plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int 1998, 19:91-97.
9. Leach R, Jones R, Silva T: Rupture of the plantar fascia in athletes. J Bone Joint Surg [Am] 1978, 60:537-539.
10. Ferrari M, Zia S, Valbonesi M. A new technique for hemodilution, preparation of autologous platelet-rich plasma intraoperative blood salvage in surgery. Int J Artif Organs., 1987; 10: 47-50.
11. Hall MP, Brand PA, Meislin RJ, et al. Platelet-rich plasma: Current concepts and application in sports medicine. J Am Acad Orthop Surg., 2009; 17: 602-609.
12. Marx R, Garg A. Dental and craniofacial applications of platelet-rich plasma. Carol Stream: Quintessence Publishing Co, Inc.; 2005.
13. Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med., 2006; 10(10): 1–5.
14. Buchbinder R. Plantar fasciitis. N Engl J Med, 2004; 350: 2159-66.
15. Tatli Y, Kapasi S. The real risks of steroid injections for plantar fasciitis, with a review of conservative therapies. Curr Rev Musculoskelet Med 2009;2(1):3–9.
16. Acevedo JI, Beskin JL. Complications of plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int 1998;19(2):91–7.
17. Molloy T, Wang Y, Murrell G. The roles of growth factors in tendon and ligament healing. Sports Med 2003;33:381–94.
18. Wrotniak M, Bielecki T, Gazdzik T. Current opinion about using the plateletrich gel in orthopaedics and trauma surgery. Orthop Traumatol Rehabil 2007;9:227–38.
19. Peerbooms J, et al. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double blind randomised controlled trial:PRPversus corticosteroid injection with a 1 year follow-up. Am J Sports Med 2010;38: 255–62.
20. Barrett S, Erredge S. Growth factors for chronic plantar fasciitis. Podiatr Today 2004;17:37–42.