scholarly journals Efficacy of platelet rich plasma injection in treatment of plantar fasciitis

Author(s):  
Rahul Kadam ◽  
Sukant Vijay ◽  
Abhay Chhallani ◽  
Santosh Pandhare ◽  
Abhishek Gupta ◽  
...  

<p class="abstract"><strong>Background:</strong> Platelet rich plasma is a recently introduced therapy for treatment of chronic painful conditions in orthopaedics, it acts mainly by promoting healing process. PRP has an increased concentration of platelets which initiate tissue repair by releasing growth factors.<span class="apple-converted-space"> </span>Increased concentrations of autologous platelets yield high concentrations of growth factors, subsequently leading to intensified healing of soft tissue on a cellular level. This study was conducted to evaluate the efficacy of platelet rich plasma injection in treatment of plantar fasciitis<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> This study was conducted on the patients coming to orthopaedic OPD at MGM medical college and hospital, kamothe, Navi Mumbai. Total of 40 planter fasciitis cases were taken in this study. Out these 40 patients 23 were Male and 17 were female. The mean age 45.85 (range 25-75). Patients were followed up for 3 months with regular interval and at each visit vas score was evaluated and noted.Total duration of study was 3 months from October 2016 to December 2016.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean pre injection vas score was 7.15 (Male – 7.13, Female – 6.70). The mean vas score at time of follow up after one week was 6.20 (Male – 6.22 Female – 6.18). The mean vas score at time of follow up after 6 week was 5.62 (Male – 5.66 Female – 5.70).  The mean vas score at time of follow up after 3 months was 3.20 (Male – 3.13 Female – 3.29)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> PRP in plantar fasciitis shows promising short term results providing patients with gradual sustained pain relief, improving daily function and lifestyle activity level. However long term results needs to be evaluated<span lang="EN-IN">.</span></p>

Author(s):  
Divya Anil Kumar ◽  
Harsha Kumar Koramutla

<p class="abstract"><strong>Background:</strong> Plantar fasciitis is a common pathological condition affecting the hind foot, and a common cause of heel pain. The present study was taken up to assess the efficacy of intralesional corticosteroid compared to autologous platelet rich plasma injection in the management of chronic plantar fasciitis.</p><p class="abstract"><strong>Methods:</strong> Patients were randomized into two groups (Group A and Group B) of 30 each. Group-A received Corticosteroid injection while Group-B received PRP injection. Patients were assessed functionally using American Orthopaedic Foot and ankle score (AOFAS), Visual analogue scale (VAS) scores before treatment and on follow-up visit at 6 weeks, 3rd month, and 6th month. Ultrasound of heel for plantar fascia thickness was measured before treatment and follow up visit at 6th month.<strong></strong></p><p class="abstract"><strong>Results:</strong> A significant decrease in VAS score was observed in the corticosteroid group compared to PRP group at 6 weeks while the VAS score continued to decrease in the PRP group at 3 months and 6 months with an increase in the corticosteroid group at 3 months and 6 months. A significant increase in AOFAS was observed in the Corticosteroid group compared to PRP group at 6 weeks which increased in the PRP group at 3 months and 6 months. However it decreased in the corticosteroid group at 3 months and 6 months. Ultrasonographic evaluation showed improvement in fascial thickness in both the groups, but was better in the PRP group.</p><p class="abstract"><strong>Conclusions:</strong> To conclude our study shows that corticosteroid is more effective for short term relief and PRP is more effective for long term relief.</p>


Author(s):  
Harpreet Singh ◽  
Malay P. Gandhi ◽  
Aliasgar J. Rampurwala ◽  
Tej S. Rudani

<p class="abstract"><strong>Background:</strong> Plantar fasciitis (PF) is considered as degenerative tendinopathies. Repeated micro trauma is the major etiology of these diseases. Autologous platelet rich plasma (PRP) injections are becoming more popular in the treatment of enthesopathies like PF. The growth factors in PRP cause tissue healing. We compared the result of injecting intra-lesional autologous PRP injections versus steroid infiltration in chronic PF.</p><p class="abstract"><strong>Methods:</strong> A prospective, interventional and analytic comparative study was done and 81 patients (120 heels) were included in this study and were followed up for 6 months. We assessed the outcome of each patient using visual analog score (VAS) and foot and ankle disability index (FADI) on follow-up at 1, 3, and 6 months. <strong></strong></p><p class="abstract"><strong>Results:</strong> In our study, female preponderance was seen. Left side was more common as compared to right side. Unilateral PF is more common than bilateral. The difference with in the individual group at baseline and at 1,3 and 6 months was statistically highly significant in terms of VAS and FADI (p=0.0001) But the difference in the between the two groups was insignificant for VAS and FADI at 1, 3 and 6 months.</p><p class="abstract"><strong>Conclusions:</strong> In our study, as there is no significant difference in VAS and FADI score between corticosteroid injection group and PRP injection group at 1, 3 and 6 months follow up. So, it’s reasonable to conclude that both are equally effective in PF. But as PRP injection comes out to be more time consuming and more costly, corticosteroid seems to be more efficient, cost and time wise. Hence, the latter should be a better choice.      </p>


2018 ◽  
Vol 12 (2) ◽  
pp. 153-158 ◽  
Author(s):  
Sarah Johnson-Lynn ◽  
Alan Cooney ◽  
Diarmaid Ferguson ◽  
Deborah Bunn ◽  
William Gray ◽  
...  

Platelet-rich plasma (PRP) has been advocated for treatment of plantar fasciitis but there are few good-quality clinical trials to support its use. We conducted a feasibility study of PRP versus saline for treatment of plantar fasciitis. Patients with 6 months or more of magnetic resonance imaging–proven plantar fasciitis, who had failed conservative treatment were invited to participate in the study. Patients were block randomized to either PRP or an equivalent volume of saline. The techniques used for injection and rehabilitation were standardized for both groups. The patient and assessor were blinded. Visual analogue scale (VAS) for pain and painDETECT score were recorded preoperatively and at 6 months follow-up. From 35 patients approached, 28 (19 female, mean age 50 years) were recruited, with 14 randomized to each arm. At 6 months, 8 patients (28.6%) were lost to follow-up. There was a significant change in VAS score from baseline to follow-up in both intervention (mean change 37.2, P = .008) and control (mean change 42.2, P = .003) groups. There was no correlation between preoperative painDETECT score and change in VAS. Recruitment and loss to follow-up rates were relatively high. Both treatments resulted in a similar, significant, improvement in symptoms. Levels of Evidence: Level II


2015 ◽  
Vol 16 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Melih Malkoc ◽  
Ozgur Korkmaz ◽  
Adnan Kara ◽  
Ismail Oltulu ◽  
Ferhat Say

ABSTRACTPlantar fasciitis is a disorder caused by inflammation of the insertion point of the plantar fascia over the medial tubercle of the calcaneus. Foot orthotics are used to treat plantar fasciitis. Heel pads medialise the centre of force, whereas medial arch supporting insoles lateralise the force. We assessed the clinical results of the treatment of plantar fasciitis with silicone heel pads and medial arch-supported silicone insoles.We retrospectively reviewed 75 patients with heel pain. A total of 35 patients in the first group were treated with medial arch supporting insoles, and 40 patients in the second group were treated with heel pads. The patients were evaluated with the Visual Analogue Scale (VAS) and the Foot and Ankle Ability Measure (FAAM) at the first and last examinations.The mean VAS score in the first group was 8.6±1,2 (6-10); the FAAM daily activity score was 66.2±16 (41.2-95.0), and the sporting activity score was 45.4±24,4 (0.1-81) before treatment. At the last follow-up in this group, the mean VAS score was 5.3±1,5 (0-9); the FAAM daily activity score was 83,0±15,1 (55,9-100), and the sporting activity score was 73,5±26,2 (25-100). The mean VAS score in the second group was 8,6±0,9 (7-10); the FAAM daily activity score was 66.4±17 (41.4-95.2), and the sporting activity score was 45.8±24,2 (0.8-81, 3) before the treatment. At the last follow-up in this group, the mean VAS score was 5.5±1,2 (0-9); the FAAM daily activity score was 83.4±14,9 (60, 2-100), and the sporting activity score was 73.8±26 (28-100).There was no significant difference in the clinical results of both groups. The force distribution by the use of silicone heel pads and medial arch-supported silicone insoles had no effect on the clinical results of the treatment of plantar fasciitis.


Author(s):  
Vithal Prakash Puri ◽  
Anil Kumar Gaur

<p class="abstract"><strong>Background:</strong> The heel pain is the most common problem worldwide and it was associated with plantar fasciitis (PF). The condition of treatment is very complex. Platelet-rich plasma (PRP) and injection of corticosteroids is the treatment of PF. This study was designed to access the effect of local PRP and local corticosteroid injection in PF patients.</p><p class="abstract"><strong>Methods:</strong> Sixty patients (between 29 to 60 years of age) with chronic PF were randomized prospectively in single tertiary care center in India. The study conducted from December 2013 to December 2015. All the patients were enrolled according to inclusion criteria and divided into two groups randomized. In group A (n=30) received PRP and group B (n=30) received corticosteroids injections. Visual analog scales (VAS) were filled by all the included patients. The follow-up scheduled at one and six months after complete enrolment of patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> Between both the groups the significantly different observed at one and six months follow-up from the baseline. At one month follow-up significantly improvement in mean VAS score were observed in group B (p&lt;0.001). At six months follow-up significantly improvement in mean VAS score were observed in group A (p&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> The present study concluded from the significance difference between both the groups proved promising form of treatment in chronic PF patients. Both the treatment was safe and effective in relieving pain improving function at different time period.</p><p> </p>


Author(s):  
Narayanan V. L. ◽  
Preetha P. ◽  
Maria Joshna J. ◽  
Mishal Dhivya P. J. ◽  
Anbu Selvan

<p class="abstract"><strong>Background:</strong> The study was conducted with the aim to explore the efficacy of platelet rich plasma in sixty patients who presented to us with lateral epicondylitis of elbow where conservative management has failed<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Between 2013 and 2015, 60 patients (M: F- 20: 40) with lateral epicondylitis of elbow were included. All patients presented to us with lateral epicondylitis of elbow where conservative management has failed. All patients are treated with platelet rich plasma injection. Serial follow-up were done at 1, 6 and 12 month.<strong></strong></p><p class="abstract"><strong>Results:</strong> All sixty patients had significant improvement before and after platelet rich plasma injection. The mean VAS score and the Mayo score suggests significant improvement in pain and elbow function following platelet rich plasma treatment<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Platelet rich plasma improves pain and elbow function in patients suffering from lateral epicondylitis where conservative management has failed. Platelet rich plasma treatment may decrease the overall time for healing, and thereby decreasing the overall need for surgical intervention<span lang="EN-IN">.</span></p>


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Antonio Crescibene ◽  
Marcello Napolitano ◽  
Raffaella Sbano ◽  
Enrico Costabile ◽  
Hesham Almolla

Achilles tendinopathy and patellar tendinopathy are among the most frequent diagnoses in sports medicine. Therapeutic treatment of the disease is difficult, particularly in chronic cases. In literature, several studies suggest the employment of Platelet-Rich Plasma as a therapeutic alternative in tendinopathies. The choice of employing this method is based on the activity of growth factors contained in platelets which activate, amplify, and optimize the healing process. We selected 14 patients affected by Achilles tendinopathy and 7 patients affected by patellar tendinopathy, with a two-year final follow-up. These patients underwent a cycle of three tendinous infiltrations, after clinical and instrumental evaluation carried out by means of specific questionnaires and repeated ultrasound scans. Ultrasound scans of 18 patients showed signs of reduction in insertional irregularities. The result is confirmed by complete functional recovery of the patients, with painful symptomatology disappearing. The patients showed a clear pain reduction, along with an enhanced VISA score after the 24-month follow-up, equal to 84.2 points on a scale of 0 to 100. In conclusion, the present study provides evidence to suggest that PRP infiltration is a valid option to patients with chronic tendinopathy who did not benefit from other treatments.


Author(s):  
Prashant Maheshwari ◽  
Hemeshwar Harshwardhan

<p class="abstract"><strong>Background:</strong> New studies focused on modern therapeutic methods which stimulate cartilage healing and repair the damage, including the use of platelet-rich plasma (PRP) as a cocktail of growth factors. This study has the purpose to present the use of PRP in management of knee osteoarthrosis and its outcomes up to 6 month follow up.</p><p class="abstract"><strong>Methods:</strong> 58 patients with 100 knees (32 male, 26 female) with Kellgren Lawrence grade 1, 2,3 and 4, aged between 50 to 65 years between February 2015 to December 2015 treated with 4 ml of intra-articular PRP injections at 4 week interval in each affected knee and evaluated using WOMAC and VAS scores before injection and on follow up at end of the 1<sup>st</sup>, 3<sup>rd</sup>, and 6<sup>th</sup> month.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age was 58.29 years. Improvement in WOMAC score for KL grade 1 (32.61%), grade 2 (31.12%), grade 3(26.54%) whereas only 13.68% in KL grade 4 at end of 6month follow up. Improvement in VAS score for KL grade 1 (41.30%), grade 2 (38.02%), grade 3 (47.68) whereas only 12.74% in grade 4 at the end of 6 month follow up. Results show statistically higher significant improvement seen in WOMAC and VAS for KL grade 1, 2, and 3 as compared to grade 4 at 6 months follow up.</p><p><strong>Conclusions:</strong> The results of our study illustrated that the treatment with intra articular PRP injections is safe and effective in reducing pain and stiffness as well as improve knee function and quality of life in early stages of knee osteoarthrosis. </p>


Author(s):  
Jitendra Singh Rathore ◽  
Lokpal Singh Bhati ◽  
Devendra Singh Rathore

Background: To study the platelet rich plasma injection in patients of chronic lateral epicondylitis Methods: This study was carried out prospectively on patients age of 18-70 years of both male and female gender suffering from lateral epicondylitis. Results: In this study we found that before injection almost patients had their VAS score were 8-10. None of the patients has been improved their VAS score to 0 at the 4th week 10.00% patients have been improved their VAS score 0 at the 4th month follow-up. Conclusion: We conclude that PRP injection significantly decrease pain and increased elbow performance at 6 months follow-up Keywords: PRP, Elbow, Modality


2011 ◽  
Vol 4 (6) ◽  
pp. 349-353 ◽  
Author(s):  
Kyung Tai Lee ◽  
Jun Beom Kim ◽  
Ki Won Young ◽  
Young Uk Park ◽  
Jin Su Kim ◽  
...  

Purpose. The objective of this retrospective study was to evaluate the long-term follow-up results of neurectomy clinical outcomes and complications in the treatment of Morton’s neuroma. Materials and methods. A total of 19 patients (19 different feet) were treated for Morton’s neuroma by excision of the interdigital nerve at our institute between May 1997 and May 1999. Thirteen (13 feet) of them were followed up. The 13 patients were female and had an average age of 43 years (range 34-54 years) at the time of the operation. The patients were followed-up for a mean of 10.5 years (range 10.0-12.2 years) and scored using the American Orthopaedic Foot & Ankle Society (AOFAS) forefoot scoring system and Visual Analogue Scale (VAS) score. Subjective satisfaction was evaluated at the final follow-up. Results. Eight patients scored more than 90 on the AOFAS forefoot scoring system. The VAS score was improved in all patients. The mean preoperative VAS score was 8.6 ± 0.8 cm (7-10) and the mean follow-up VAS score was 2.4 ± 1.8cm (0-6), which indicated no significant difference (P > .05). The final follow-up satisfaction results indicated that 4 patients were completely satisfied with the operation, 4 were satisfied with minor reservations, 5 were satisfied with major reservations, and no patient was unsatisfied. Neurectomy to treat Morton’s neuroma had a good satisfaction rate (61%). Eleven of the patients complained of numbness on the plantar aspect of the foot adjacent to the interspace, and 2 of these 11 patients complained of disability induced by severe numbness. There was a complaint of residual pain by 1 patient. There were no skin problems on the operation lesions. Conclusion. The long-term results of neurectomy clinical outcomes in Morton’s neuroma are slightly worse than the short- and mid-term results. Levels of Evidence: Therapeutic, Level IV, Retrospective case series


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