DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20175468

Role of leukocyte free platelet rich plasma in planter fasciitis: a prospective study

Chandre Shekhar, Alamgir Jhan, Ganesh Singh, Pankaj Singh, Shailendre S. Bhandhari

Abstract


Background: Planter fasciitis, is by definition, inflammation of planter fascia. Most of the cases are well treated conservatively and a few responds to surgery only. Objectives of present study were evaluating the efficacy of a single injection of leukocyte free platelet rich plasma in plantar fasciitis and to derive a correlation between the clinical and radiological outcome.

Methods: The present study consisted of 120 patients of bilateral (PF), (240 feet). These patients were divided into two groups PRP group of 60 patients and Placebo group of 60 patients. The study was conducted on patients attending Orthopaedics outpatient department Post Graduate Institute of Medial Education and Research (PGIMER) from July 2011 to June 2012. A primary efficacy criterion was changes from baseline in pain using (VAS). Functional results, level of satisfaction and outcome were measured by – AOFAS Foot Scale. Correlation of clinical with radiological outcome were performed.

Results: There was a significant decrease in the visual analogue scale (pain score) in the PRP. Group while in placebo group it was increased significantly at the end of 6 month. Functional outcome scores were improved significantly from their baseline values in PRP group while in placebo group the mean functional score were deteriorated at 6 months follow up. There was no improvement seen in functional status with normal saline injection. In PRP group the mean heal pad thickness was reduced significantly at 6 months follow up while in placebo group was not changed significantly at 6 months follow up. Correlation between radiological parameters and VAS was found to be positive while it was found negative with other functional outcome scores like AOFAS.

Conclusions: Platelet-rich plasma (PRP), which is a natural concentrate of autologous growth factors,plays a role in the regeneration process in treatment of (PF).


Keywords


Planter, Platelet, Plasma, PRP

Full Text:

PDF

References


Lemont H, Ammirati KM, Usen N. plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Chiro Assoc. 2003;93:234-7.

Jarde O, Diebold P, Havet E, Boulu G, Vernois J. Assessing obesity, classification and epidemiology. British Bulletin. 2003;21(4):147-64.

Fadale PD, Wiggins ME. Corticosteroid injections: their use and abuse. J Am Acad Ortho P Surg. 1994;2:133-40.

Nirshl R. Elbow tendinosis/tennis elbow. Clin Sports Med. 1992;11:851-70.

Ranly D, Lohman C, Andreacchio D, Boyan B, Schwartz Z Platelet-rich plasma inhibits demineralized bone matrix-induced bone formation in nude mice. J Bone Joint Surg. 2007;89:139-47.

Edwards S, Calandruccio J. Autologous blood injections for refractory lateral epicondylitis. J Hand Surg Am. 2003;28:272-8.

Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent. 2001;10:225-8.

Antitua E, Sanchez M, Nurden AT, Nurden P, Orive G, Andia I. New insights into and novel applications for platelet-rich therapies. Trends Biotechnol. 2006;24:227-34.

Kajikawa Y, Morihara T, Sakamato H, Matsuda K, Oshima Y, Yoshida A et al. Platelet-rich plasma enhances the initial mobilization of circulation derived cells for tendon healing. J cell Physiol. 2008;215(3):837-45.

Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet rich plasma. Am J Sports Med. 2006;34:1774-8.

Peerbooms JC, Sluimer J, Bruijn DJ, et al. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: plateletrich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med. 2010;38:255-62.

Creaney L, Wallace A, Curtis M, Connell D. Growth factor-based therapies provide additional benefit beyond physical therapy in resistant elbow tendinopathy: a prospective, single blind, randomised trial of autologous blood injections versus platelet-rich plasma injections. Br J Sports Med. 2011;45:966-71.

Barrett S, Erredge S. Growth factors for chronic plantar fasciitis. Podiatry Today. 2004;17:37-42.

Seidell JC, Flegal KM. Assessing obesity: classification and epidemiology. Br Med Bull. 1997;53(2):238-52.

Irving DB, Cook JL, Young MA, Menz HB. Impact of Chronic heel pain on health related Quality of life. J Am Podiatry Med Assoc. 2008;29:283-9.

Cornwall MW, McPoil TG. Plantar fasciitis etiology and treatment. J Ortho Sports Phys Ther. 1992;29:756-60.

Davies MS, Weiss GA, Saxby TS. Plantar fasciitis: how successful is surgical intervention? Foot Ankle Int. 1999;20:803-7.

Acebedo JL, Betts RP. Complications of plantar fascia rupture associated with corticosteroid injection. Foot Ankle. 1998;19:91-7.

Chandler TJ, Kibler WB. A biomechanical approach to prevention, treatment and rehabilitation of plantar fasciitis. Sports Med. 1999;15:344-52.

Andrew M, Karl B, Mark F, Adam R, Adam D, Hylton B. Ultrasound guided corticosteroid injection for plantar fasciitis: randomised controlled trial BMJ 2012;344:e3260.

Lee TG, Ahmad TS. Intralesional autologous blood injection compared to corticosteroid injection for treatment of chronic plantar fasciitis. A prospective randomized, controlled trial. Foot Ankle Int. 2007;28(9):984-90.

Peerbooms JC, Wilbert V, Frank F, Hans M, Henk V and Taco G. Use of platelet rich plasma to treat plantar fasciitis: design of a multi centre randomized controlled trial. BMC Musculoskeletal Disorders. 2010;11:69.

Ertugrul A, Dafhan D, Halil Y, Onur H, Ozgur D, Levent C et al. The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis. Arch Orthop Trauma Surg. 2012;132:781-5.

Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-richplasma. Am J Sports Med. 2006;34:1774-8.

De Vos RJ, Weir A, van Schie H, et al. Platelet-rich plasma injection for chronic Achilles tendinopathy. JAMA. 2010;303:1449.

Othman AM, Raqab EM. Endoscopic plantar fasciotomy versus extracorporeal shock wave therapy for treatment of chronic plantar fasciitis. Arch Orthop Trauma Surg. 2010;130(11):1343-7.

Tiwari M, Bharqava R. Platelet rich plasma therapy: A comparative effective therapy with promising results in plantar fasciitis. J Clin Orthop Trauma. 2013;4(1):31-5.

Sahu RL. Percutaneous planter fasciitis release under local anesthesia: A prospective study. Clin J Traumatol. 2017;20(2):87-9.