Plantar Fasciitis—A Comparison of Treatment with Intralesional Steroids versus Platelet-Rich Plasma

Journal of the American Podiatric Medical Association - Tập 107 Số 6 - Trang 490-496 - 2017
Carlos Acosta‐Olivo1, Jorge Elizondo-Rodríguez1, Ricardo Lopez-Cavazos1, Félix Vílchez‐Cavazos1, Mario Simental‐Mendía1, Oscar Fernando Mendoza-Lemus1
1Department of Orthopedics and Traumatology, Universi-dad Autonoma de Nuevo Leon, Nuevo Leon, Mexico.

Tóm tắt

Background:Many treatment options for plantar fasciitis currently exist, some with great success in pain relief. The objective of our study was to compare the use of intralesional steroids with platelet-rich plasma (PRP), using pain scales and functional evaluation, in patients with plantar fasciitis who did not respond to conservative treatment.Methods:A controlled, randomized, blinded clinical assay was performed. Patients were assigned to one of the two groups by selecting a sealed envelope. The steroid treatment group received 8 mg of dexamethasone plus 2 mL of lidocaine as a local anesthetic. The PRP treatment group received 3 mL of PRP activated with 0.45 mL of 10% calcium gluconate. All of the patients were evaluated at the beginning of the study, and at 2, 4, 8, 12, and 16 weeks post-treatment with the Visual Analog Scale (VAS), Foot and Ankle Disability Index (FADI), and American Orthopedic Foot and Ankle Society (AOFAS) scale.Results:The right foot was the most frequently affected foot (63%). The average age of the patients was 44.8 years (range, 24–61 years). All scales used (VAS, FADI and AOFAS) showed that the difference was not statistically significant between the two groups.Conclusions:We can conclude that the use of PRP is an effective treatment method for patients with plantar fasciitis who do not respond to conservative treatment because PRP demonstrates an efficacy equal to that of steroids. However, the cost and the time for preparation the PRP are two of the disadvantages of this treatment.

Từ khóa


Tài liệu tham khảo

Sanchez, 2007, Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices, Am J Sports Med, 35, 245, 10.1177/0363546506294078

Buchbinder, 2004, Clinical practice: Plantar fasciitis, N Engl J Med, 350, 2159, 10.1056/NEJMcp032745

Buchbinder, 2004, Clinical practice: Plantar fasciitis, N Engl J Med, 350, 2159, 10.1056/NEJMcp032745

Martinelli, 2013, Platelet-rich plasma injections for chronic plantar fasciitis, Int Orthop, 37, 839, 10.1007/s00264-012-1741-0

DeLong, 2012, Platelet-rich plasma: The PAW classification system, Arthroscopy, 28, 998, 10.1016/j.arthro.2012.04.148

DeLong, 2012, Platelet-rich plasma: The PAW classification system, Arthroscopy, 28, 998, 10.1016/j.arthro.2012.04.148

Shetty, 2014, A study to compare the efficacy of corticosteroid therapy with platelet-rich plasma therapy in recalcitrant plantar fasciitis: A preliminary report, Foot Ankle Surg, 20, 10, 10.1016/j.fas.2013.08.002

Crawford, 2003, Interventions for treating plantar heel pain, Cochrane Database Syst Rev, 3, CD000416

Tatli, 2009, The real risks of steroid injection for plantar fasciitis, with a review of conservative therapies, Curr Rev Musculoskelet Med, 2, 3, 10.1007/s12178-008-9036-1

Crawford, 2003, Interventions for treating plantar heel pain, Cochrane Database Syst Rev, 3, CD000416

Gill, 1996, Outcome of nonsurgical treatment for plantar fasciitis, Foot Ankle Int, 17, 527, 10.1177/107110079601700903

Kitaoka, 1994, Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes, Foot Ankle Int, 15, 349, 10.1177/107110079401500701

DiGiovanni, 2006, Plantar fascia-specific excercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up, J Bone Joint Surg Am, 88, 1775, 10.2106/JBJS.E.01281

Mazzocca, 2012, Platelet-rich plasma differs according to preparation method and human variability, J Bone Jone Srug Am, 94, 308, 10.2106/JBJS.K.00430

Marx, 2004, Platelet-rich plasma: Evidence to support its use, J Oral Maxillofac Surg, 62, 489, 10.1016/j.joms.2003.12.003

Harmon, 2013, The use of platelet-rich plasma in the nonsurgical management of sports injuries: hype or hope?, Hematology Am Soc Hematol Educ Program, 2013, 620, 10.1182/asheducation-2013.1.620

Huskisson, 1974, Measurement of pain, Lancet, 2, 1127, 10.1016/S0140-6736(74)90884-8

Thomas, 2010, The diagnosis and treatment of heel pain: A clinical practice guideline-revision 2010, J Foot Ankle Surg, 49, S1, 10.1053/j.jfas.2010.01.001

Giusti, 2009, Identification of an optimal concentration of an optimal concentration of platelet gel for promoting angiogenesis in human endotelial cells, Transfusion, 49, 771, 10.1111/j.1537-2995.2008.02033.x

Lemont, 2003, Plantar fasciitis: a degenerative process (fasciosis) without inflammation, JAPMA, 93, 234, 10.7547/87507315-93-3-234

Sellman, 1994, Plantar fasciitis ruptura associated with corticosteroid injection, Foot Ankle Int, 15, 376, 10.1177/107110079401500706

Aksahin, 2012, The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis, Arch Orthop Trauma Surg, 132, 781, 10.1007/s00402-012-1488-5

Kitaoka, 1994, Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes, Foot Ankle Int, 15, 349, 10.1177/107110079401500701

Mazzucco, 2009, Not every PRP-gel is born equal: Evaluation of growth factor availability for tissues through four PRP-gel preparation. Fibrinet, RegenPRP-Kit, Plateltex and one manual procedure, Vox Sang, 97, 110, 10.1111/j.1423-0410.2009.01188.x

Huskisson, 1974, Measurement of pain, Lancet, 2, 1127, 10.1016/S0140-6736(74)90884-8

Thomas, 2010, The diagnosis and treatment of heel pain: A clinical practice guideline-revision 2010, J Foot Ankle Surg, 49, S1, 10.1053/j.jfas.2010.01.001

Giusti, 2009, Identification of an optimal concentration of an optimal concentration of platelet gel for promoting angiogenesis in human endotelial cells, Transfusion, 49, 771, 10.1111/j.1537-2995.2008.02033.x

Aksahin, 2012, The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis, Arch Orthop Trauma Surg, 132, 781, 10.1007/s00402-012-1488-5

Martin, 1999, Development of the foot and ankle disability index (FADI), J Orthop Sports Phys Ther, 29, A32

Eppley, 2004, Platelet quantification and growth factor analysis from platelet-rich plasma: Implications for wound healing, Plast Reconstr Surg, 114, 1502, 10.1097/01.PRS.0000138251.07040.51

Riddle, 2004, Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: A national study of medical doctors, Foot Ankle Int, 25, 303, 10.1177/107110070402500505

Ragab, 2012, Platelets rich plasma for treatment of chronic plantar fasciitis, Arch Orthop Trauma Surg, 132, 1065, 10.1007/s00402-012-1505-8

Mishra, 2006, Treatment of chronic elbow tendinosis with buffered platelet rich plasma, Am J Sport Med, 34, 1774, 10.1177/0363546506288850

Marx, 2004, Platelet-rich plasma: Evidence to support its use, J Oral Maxillofac Surg, 62, 489, 10.1016/j.joms.2003.12.003

Riddle, 2003, Risk factors for plantar fasciitis: A matched case-control study, J Bone Joint Surg Am, 85, 872, 10.2106/00004623-200305000-00015

DiGiovanni, 2006, Plantar fascia-specific excercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up, J Bone Joint Surg Am, 88, 1775, 10.2106/JBJS.E.01281

Martinelli, 2013, Platelet-rich plasma injections for chronic plantar fasciitis, Int Orthop, 37, 839, 10.1007/s00264-012-1741-0

Fufa, 2008, Activation of platelet-rich plasma using soluble type I collagen, J Oral Maxillofac Surg, 66, 684, 10.1016/j.joms.2007.06.635

O'Malley, 2013, Successful use of platelet-rich plasma for chronic plantar fasciitis, HSS J, 9, 129, 10.1007/s11420-012-9321-9

Mishra, 2009, Treatment of tendon and muscle using platelet-rich plasma, Clin Sports Med, 28, 113, 10.1016/j.csm.2008.08.007

O'Malley, 2013, Successful use of platelet-rich plasma for chronic plantar fasciitis, HSS J, 9, 129, 10.1007/s11420-012-9321-9

Lemont, 2003, Plantar fasciitis: a degenerative process (fasciosis) without inflammation, JAPMA, 93, 234, 10.7547/87507315-93-3-234

Acevedo, 1998, Complications of plantar fascia rupture associated with corticosteroid injection, Foot Ankle Int, 19, 91, 10.1177/107110079801900207

Gill, 1996, Outcome of nonsurgical treatment for plantar fasciitis, Foot Ankle Int, 17, 527, 10.1177/107110079601700903

Acevedo, 1998, Complications of plantar fascia rupture associated with corticosteroid injection, Foot Ankle Int, 19, 91, 10.1177/107110079801900207

Riddle, 2004, Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: A national study of medical doctors, Foot Ankle Int, 25, 303, 10.1177/107110070402500505

Irving, 2006, Factors associated with chronic plantar heel pain: a systematic review, J Sci Med Sport, 9, 11, 10.1016/j.jsams.2006.02.004

Mazzocca, 2012, Platelet-rich plasma differs according to preparation method and human variability, J Bone Jone Srug Am, 94, 308, 10.2106/JBJS.K.00430

Fufa, 2008, Activation of platelet-rich plasma using soluble type I collagen, J Oral Maxillofac Surg, 66, 684, 10.1016/j.joms.2007.06.635

Tatli, 2009, The real risks of steroid injection for plantar fasciitis, with a review of conservative therapies, Curr Rev Musculoskelet Med, 2, 3, 10.1007/s12178-008-9036-1

Riddle, 2003, Risk factors for plantar fasciitis: A matched case-control study, J Bone Joint Surg Am, 85, 872, 10.2106/00004623-200305000-00015

Shetty, 2014, A study to compare the efficacy of corticosteroid therapy with platelet-rich plasma therapy in recalcitrant plantar fasciitis: A preliminary report, Foot Ankle Surg, 20, 10, 10.1016/j.fas.2013.08.002

Mishra, 2009, Treatment of tendon and muscle using platelet-rich plasma, Clin Sports Med, 28, 113, 10.1016/j.csm.2008.08.007

Eppley, 2004, Platelet quantification and growth factor analysis from platelet-rich plasma: Implications for wound healing, Plast Reconstr Surg, 114, 1502, 10.1097/01.PRS.0000138251.07040.51

Irving, 2006, Factors associated with chronic plantar heel pain: a systematic review, J Sci Med Sport, 9, 11, 10.1016/j.jsams.2006.02.004

Sellman, 1994, Plantar fasciitis ruptura associated with corticosteroid injection, Foot Ankle Int, 15, 376, 10.1177/107110079401500706

Sanchez, 2007, Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices, Am J Sports Med, 35, 245, 10.1177/0363546506294078

Mazzucco, 2009, Not every PRP-gel is born equal: Evaluation of growth factor availability for tissues through four PRP-gel preparation. Fibrinet, RegenPRP-Kit, Plateltex and one manual procedure, Vox Sang, 97, 110, 10.1111/j.1423-0410.2009.01188.x

Mishra, 2006, Treatment of chronic elbow tendinosis with buffered platelet rich plasma, Am J Sport Med, 34, 1774, 10.1177/0363546506288850

Ragab, 2012, Platelets rich plasma for treatment of chronic plantar fasciitis, Arch Orthop Trauma Surg, 132, 1065, 10.1007/s00402-012-1505-8

Harmon, 2013, The use of platelet-rich plasma in the nonsurgical management of sports injuries: hype or hope?, Hematology Am Soc Hematol Educ Program, 2013, 620, 10.1182/asheducation-2013.1.620

Martin, 1999, Development of the foot and ankle disability index (FADI), J Orthop Sports Phys Ther, 29, A32