Chronic plantar fasciitis is commonly diagnosed in patients, but can be a difficult condition to treat successfully. Platelet rich plasma (PRP) is the injection of concentrated platelets that is abundant with cytokines (immunomodulation agents) and other growth elements. PRP injection was compared to cortisone injection when treating severe cases of plantar fasciitis that are resistant to the traditional non-operative treatments.
A sample of thirty-six patients was randomized into two study groups and prospectively evaluated. This sample involved 16 males and 20 females who were diagnosed with severe chronic plantar fasciitis and were non responsive to the traditional non-operative treatments such as rest, cam walker immobilization, heel lifts, night splinting, PT, local modalities, and NSAIDS. Before starting the treatment all of the patients had MRI and ultrasound studies which were consistent with plantar fasciitis. The first group was treated with a single 40 mg methylprednisolone ultrasound-guided injection of at the site of the injury. The second group was treated with a single un-buffered autologous PRP ultrasound-guided injection at the site of the injury. For the two weeks of the study the patients were immobilized fully weight bearing in a cam walker. Then they were started on home exercises after which they were allowed to return to their regular activities as their pain would permit without the extra support.
The study was judged based on The American Orthopedic Foot and Ankle Score (AOFAS) which is designed to evaluate the healing process of ankle and foot surgery. The first group originally had the OAFAS score of 52, which increased to 81 after three months, then decreased to 74 after 6 months and further decreased to 58 after 12 months. The second group had original score of 37 which then increased to .95 after 3 months and remained at 94 after 6 and after 12 months following the treatment.
These finding suggests that platelet rich plasma injection is a better and longer-lasting treatment than cortisone injection when treating severe chronic plantar fasciitis.
