Local injection of autologous platelet rich plasma compared to corticosteroid treatment of chronic plantar fasciitis patients: A clinical and ultrasonographic follow-up study

Abstract

Platelet-rich plasma (PRP) has been gaining popularity as a treatment for plantar fasciitis (PF). To compare local autologous PRP and steroid injections both clinically and sonographically within 3-months and also regarding its safety. This study was carried out on 50 patients with chronic PF divided into two groups: steroid and PRP groups (n = 25 each). Patients were assessed by visual analog scale (VAS), Foot Health Status Questionnaire (FHSQ) and ultrasonography at 1.5 and 3 months post-injection. The 50 patients had comparable disease duration (p > 0.5). At 1.5 months post-injection, there was more improvement in the PRP than in the steroid group both clinically (as assessed by the VAS) and ultrasonographically (as regards the echogenicity) (p = 0.008 and p < 0.01, respectively). There was no significant difference between both groups at 3 months. The echogenicity significantly improved at 3 months post-injection within each group (p < 0.0001). Regarding thickness, the difference did not reach significance (p = 0.11, p > 0.05). No significant difference was present between the 2 groups regarding the reduction plantar fascia thickness at 1.5 (p = 0.89) and 3 months (p = 0.64) post-injection. Regarding the safety of both injections, none of our patients in either group developed any significant complications. We suggest that the PRP injection is a new, readily available, well tolerated and safe choice of therapy for chronic PF and is not inferior to steroid injection in a short term 3 month follow up. Comparing the long-term efficacy both clinically and sonographically is necessary to confirm their sustained effect.