Comparative Study of Efficacy of Single Injection of Platelet-rich Plasma with Steroid Injection in Treatment of Plantar Fasciitis

Volume 6 | Issue 2 | May-Aug 2018 | Page: 29-34 | Vanamali B Seetharam, B Sunil, K B Srinath Reddy, Narayan Naik

Authors: Vanamali B Seetharam [1], B Sunil [1], K B Srinath Reddy [1], Narayan Naik [1].

[1] Department of Orthopaedics, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.

Address of Correspondence
Dr. B Sunil,

Department of Orthopaedics, K.R Road, Fort,

Bangalore Medical College and Research Institute,

Bengaluru – 560 002, Karnataka, India.

E-mail: comsunil_bee@yahoo.co.in

Abstract

Background: Plantar fasciitis (PF) is a degenerative condition which can be painful and debilitating with well-recognized clinical presentation. Although most patients with this condition eventually have satisfactory outcomes with nonsurgical treatment, sometimes PF can be a difficult problem to treat. For patients who do not improve after initial treatment, corticosteroid injection or dexamethasone iontophoresis may provide short-term benefit. However, these therapies do not improve long-term outcomes and may cause plantar fascia rupture. Recent studies have indicated platelet-rich plasma (PRP) might be promising treatment modality in chronic cases of PF.

Materials and Methods: Prospective study conducted at tertiary care research institute comparing the efficacy of single injection of PRP with a steroid. A total of 80 patients with PF of more than 3 months were subjected to routine blood investigation, X-rays of the foot with ankle and were categorized into two groups. The first group received local infiltration of 1 ml of autologous PRP and the second group received 1 ml Triamcinolone  injection. After injection, all patients were prescribed combination of paracetamol and tramadol orally for pain relief and were advised plantar fascia stretching exercises, soft footwear. Visual analog scale and foot and ankle outcome scores were recorded on day 0, at 12 and 24 weeks.

Results: The results were analyzed using nonparametric tests such as Chi-square and Fisher Exact tests. The pain relief at 3 months was comparable in both groups, but at 6 months pain relief was greater in the PRP group, and the difference was statistically significant (P <0.001). The complications in steroid group were hypopigmentation with subdermal atrophy, and no complications were reported in PRP group.

Conclusion: Efficacy of single injection of PRP to relieve the pain of PF is better than triamcinolone over a short-term follow-up period. However, more multicenter studies are required to evaluate the efficacy of PRP over the long term.

Keywords: Plantar fasciitis, platelet-rich plasma, steroid, visual analog scale score, foot and ankle outcome score.

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