Abstract :
Introduction: Plantar Fasciitis is one of the commonest causes of heel pain and can be very challenging for clinicians to treat it successfully in the long run. The results of using autologous platelet-rich plasma(PRP) to treat chronic plantar fasciitis have been very encouraging but there is a dearth of literature comparing its effectiveness with steroid injection in long term for the treatment of chronic plantar fasciitis. This prospective comparative study is conducted to compare the efficacy of PRP over corticosteroids.
Materials and Methods: We conducted this prospective comparative study between PRP and steroid injection by enrolling patients who failed the conservative line of management for 6 weeks period. We sequentially followed up the patient at discharge from the hospital, 6 weeks, 3 months, 6 months, and one year. The preoperative and postoperative function was assessed with The American Orthopaedic Foot and Ankle SocietyAOFAS) Score including pain, function, alignment components along with the Visual Analog Scale(VAS) score for pain. Inter and Intragroup comparisons were made with student t-test and paired t-test
respectively.
Results: 50 patients with a mean age of 37.2 years were enrolled in the study. In comparison, the PRP group showed a significant improvement in the AOFAS score at 6 months (p=0.021) and 1 year(p=0.001) compared to the corticosteroid injection. However, the reduction in pain by the VAS score was comparable between the two groups at 6 months (p=0.542) and one year (p=0.224) respectively.
Conclusion: While both PRP and corticosteroid injection significantly reduces the pain at 1-year followup, functional improvement is significantly better in the PRP group compared to the steroids. PRP injection therapy remains more effective compared to steroid injection in the management of recalcitrant plantar fasciitis considering the degenerative component of the disease entity.
Keyword :
Platelet Rich Plasma, Corticosteroid, Plantar Fasciitis.