Platelet-Rich Plasma Efficacy Versus Corticosteroid Injection Treatment for Chronic Severe Plantar Fasciitis
Abstract
Background:
Chronic plantar fasciitis is a common orthopedic condition that can prove difficult to successfully treat. In
this study, autologous platelet-rich plasma (PRP), a concentrated bioactive blood component rich in cytokines and growth
factors, was compared to traditional cortisone injection in the treatment of chronic cases of plantar fasciitis resistant to
traditional nonoperative management.
Methods:
Forty patients (23 females and 17 males) with unilateral chronic plantar fasciitis that did not respond to a
minimum of 4 months of standardized traditional nonoperative treatment modalities were prospectively randomized and
treated with either a single ultrasound guided injection of 3 cc PRP or 40 mg DepoMedrol cortisone. American Orthopedic
Foot and Ankle Society (AOFAS) hindfoot scoring was completed for all patients immediately prior to PRP or cortisone
injection (pretreatment = time 0) and at 3, 6, 12, and 24 months following injection treatment. Baseline pretreatment
radiographs and MRI studies were obtained in all cases to confirm the diagnosis of plantar fasciitis.
Results:
The cortisone group had a pretreatment average AOFAS score of 52, which initially improved to 81 at 3 months
posttreatment but decreased to 74 at 6 months, then dropped to near baseline levels of 58 at 12 months, and continued
to decline to a final score of 56 at 24 months. In contrast, the PRP group started with an average pretreatment AOFAS
score of 37, which increased to 95 at 3 months, remained elevated at 94 at 6 and 12 months, and had a final score of 92
at 24 months.
Conclusions:
PRP was more effective and durable than cortisone injection for the treatment of chronic recalcitrant cases
of plantar fasciitis.