Platelet Rich Plasma for plantar fasciitis

NewsBot · Feb 17, 2012

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Platelet-Rich Rich Plasma is More Effective than Cortisone for Chronic Severe Plantar Fasciitis
Raymond R. Monto
Presented at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting. Feb. 7-11. San Francisco.

INTRODUCTION
Chronic plantar fasciitis is a common but sometimes difficult condition to successfully treat. Platelet rich plasma (PRP), a concentrated bioactive component of autologous blood that is rich in cytokines and other growth factors, was compared with cortisone injection in the treatment of severe cases of plantar fasciitis resistant to traditional non-operative paradigms.

METHODS
Thirty-six patients (16 males, 20 females) with severe chronic plantar fasciitis who had failed traditional non-operative treatment (rest, heel lifts, PT, NSAIDS, cam walker immobilization, night splinting, local modalities) were randomized into two study groups and evaluated prospectively. All patients had pre-treatment MRI and ultrasound studies consistent with plantar fasciitis. Group 1 was treated with a single ultrasound-guided injection of 40 mg methylprednisolone at the injury site and Group 2 was treated with a single ultrasound-guided injection of un-buffered autologous PRP at the injury site. All patients were then immobilized fully weight bearing in a cam walker for two weeks, started on eccentric home exercises and then allowed to return to normal activities as tolerated and without support.

RESULTS
Group 1 had an average age of 59 (24-74) and had failed 5.4 months (4-24) of standard non-operative management and had pre-treatment AOFAS scores of 52 (24-60). The PRP group had an average age of 51 (21-67) and had failed 5.7 months (4-26) of standard non-operative management and had pre-treatment AOFAS scores of 37 (30-56). Post-treatment AOFAS scores in Group 1 initially improved to 81 (60-90) at three months but decreased to 74 (56-85) at six months and dropped further to 58 (45-77) at 12 months follow up. Post-treatment AOFAS scores in Group 2 improved to 95 (84-90) at three months and remained excellent at 94 (87-100) at six months and stayed at 94 (86-100) at 12 months follow up (CI 95% P=0.001). No patients were lost to follow up.

DISCUSSION AND CONCLUSION
This study suggests that platelet rich plasma injection is significantly more effective and durable than cortisone injection for the treatment of severe chronic plantar fasciitis refractory to traditional non-operative management.
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NewsBot · Mar 10, 2012

Re: Platelet Rich Plasma for Musculoskeletal Conditions

The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis.
Akşahin E, Doğruyol D, Yüksel HY, Hapa O, Doğan O, Celebi L, Biçimoğlu A
Arch Orthop Trauma Surg. 2012 Mar 8;

INTRODUCTION: In this study, the results of local injection of platelet-rich plasma (PRP) and corticosteroids in the treatment of plantar fasciitis were compared.

PATIENTS AND METHODS: Sixty patients who were diagnosed as plantar fasciitis and treated conservatively for at least 3 months and had no response to conservative treatment modalities were involved in this study. The first 30 consecutive patients were treated by local injection of 2 mL of 40 mg Methylprednisolone with 2 mL of 2% prilocaine (metilprednizalone) and the second 30 patients were treated by injecting 3 mL PRP after 2 mL of 2% prilocaine injection. Patients were evaluated according to the modified criteria of the Roles and Maudsley scores and visual analog scale before injection and 3 weeks and 6 months following injection.

RESULTS: The mean VAS heel pain scores measured 6 months after treatment were 3.4 in steroid group and 3.93 in PRP group, and the scores in both groups were significantly lower when compared with pretreatment levels (6.2 in steroid group and 7.33 in PRP group). There was no significant difference between steroid and PRP groups in visual analog scale scores and modified criteria of the Roles and Maudsley scores measured at 3 weeks and 6 months (P > 0.05).

CONCLUSION: Our results revealed that both methods were effective and successful in treating plantar fasciitis. When the potential complication of corticosteroid treatment was taken into consideration, PRP injection seems to be safer and at least having same effectivity in the treatment of plantar fasciitis.
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Admin2 · Mar 10, 2012

Related threads:
Other threads tagged with platelet rich plasma
Other threads tagged with plantar fasciitis

DaVinci · Mar 10, 2012

Re: Platelet Rich Plasma for Musculoskeletal Conditions

NewsBot said: ↑

The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis.
Akşahin E, Doğruyol D, Yüksel HY, Hapa O, Doğan O, Celebi L, Biçimoğlu A
Arch Orthop Trauma Surg. 2012 Mar 8;

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NewsBot said: ↑

Platelet-Rich Rich Plasma is More Effective than Cortisone for Chronic Severe Plantar Fasciitis
Raymond R. Monto
Presented at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting. Feb. 7-11. San Francisco.
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Spot the difference? Who are you going to believe?

NewsBot · Apr 20, 2012

Platelet-rich plasma for managing calcaneus tendon tendinopathy and plantar fasciitis
López-Gavito E, Gómez-Carlín LA, Parra-Téllez P, Vázquez-Escamilla J.
Acta Ortop Mex. 2011 Nov-Dec;25(6):380-5.

INTRODUCTION:
Non-surgical treatment of Achilles tendinopathies ad plantar fasciitis has shown good results in up to 90% of cases. However, the remaining 10% of patients with these conditions represent a true challenge for the orthopedic surgeon. New technologies for the development of orthobiologic materials make it possible to use platelet-rich plasma (PRP) as an alternative to treat cases that have been refractory to prior treatment and that have a chronicity exceeding 12 months.

MATERIAL AND METHODS:
Prospective, analytical study. Patients with diagnosis of Achilles tendinopathy, plantar fasciitis or both, with a course of more than 12 months, previously treated with non-surgical alternatives, without any clinical improvement. The AOFAS hindfoot scale was used, together with the Visual Analog Scale (VAS) for pain, and photographic documentation at 2, 4, 8 and 12 months after infiltration. A treatment program that included immobilization, NSAIDs, eccentric exercises for the Achilles-calcaneal-plantar system and strengthening of the sural triceps was established. The statistical analysis included measurements of the central trend and scatter with the SPSS 15.

RESULTS:
A sample consisting of 10 patients (12 feet) that met the diagnostic and inclusion criteria was obtained. Mean age at the time of presentation was 43 years (range 23-56), with females being predominant (70%) and 50% laterality for the right and left feet. The initial AOFAS score was 39 (range 28-68) and the VAS score was 9 (range 7-10). By week 16 the AOFAS score had increased to 97 (range 88-99) and the VAS score was 2 (range 1-4). All patients resumed independent gait.

CONCLUSION:
The use of PRP in patients with Achilles tendinopathy and plantar fasciitis is an effective and safe alternative for the management of patients with a poor response to conventional non-surgical treatment. Other non-surgical modalities are recommended besides PRP for the treatment of these patients to achieve appropriate results.
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Admin2 · Apr 22, 2012

From This is Leicestershire
Agony over as new treatment gets Fleur back on to her feet

Fleur Allen thought she had tried everything possible to alleviate the crippling pain she has suffered in the soles of her feet for the past four years.

Steroids, painkillers, insoles, electric shocks, ultrasound and physiotherapy – nothing helped.
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The pain was caused by damaged tissue in her feet, a condition known as plantar fasciitis.
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Now, a simple procedure which involved taking a teaspoonful of blood out of her arm and injecting it into her foot has proved the unlikely remedy.
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Dr Wheeler said: "Blood contains a lot of different things, including chemicals which promote healing.

"The injections almost guarantee success to the vast majority of patients.
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Full story

NewsBot · May 5, 2012

Platelets rich plasma for treatment of chronic plantar fasciitis.
Ragab EM, Othman AM.
Arch Orthop Trauma Surg. 2012 May 4.

BACKGROUND:
Plantar fasciitis is a common cause of heel pain in adults. Many treatment options exist. Platelets rich plasma (PRP) is derived from autologous blood and contains high concentration of growth factors necessary for tissue healing. The use of PRP in the treatment of plantar fasciitis is a fairly recent and evolving concept. The purpose of our work was to study the effectiveness of PRP treatment for chronic plantar fasciitis.

MATERIALS AND METHODS:
Between February 2010 and June 2011, 25 patients with chronic plantar fasciitis with a mean age of 44 years were treated by PRP injection and included in this prospective study. All patients were assessed for the pain on Visual Analogue Scale (VAS) pre-injection and post-injection. Using ultrasound, the thickness of the plantar fascia was measured prior to the injection of PRP and at each visit of follow-up after injection. The mean follow-up was 10.3 months.

RESULTS:
Using a visual analog pain scale, the average pre-injection pain in patients of was 9.1 (range 8-10). Prior to injection, 72 % of patients had severe limitation of activities, and 28 % of patients had moderate limitation of activities. Average post-injection pain decreased to 1.6. Twenty-two patients (88 %) were completely satisfied, two patients (8 %) were satisfied with reservations, and one patient (4 %) was unsatisfied with using the visual analog scale. Fifteen patients (60 %) had no functional limitations post-injection and eight patients (32 %) had minimal functional limitations. Two patients (8 %) had moderate functional limitations post-injection. Twenty PRP injections. Ultrasonography, we noted significant changes not only in thickness but also in the signal intensity of the plantar fascia after PRP injection. None of our patients experienced any complications from PRP injection at the end of follow-up period.

CONCLUSION:
Injection of PRP is safe and doesn't affect the biomechanical function of the foot. Our successful early findings with injection of PRP indicate that this may become a very commonly used modality in treating this difficult condition.
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Paul Bowles · May 7, 2012

So what is it: A DIFFICULT CONDITION: much like how I would describe my first relationship when I was 15

OR

A CONDITION WHICH IS DIFFICULT TO TREAT: aka Plantar Fasciosis.

:)

In the 1700's PRP therapy would have been called witch-craft!

NewsBot · Jun 1, 2012

Platelet-rich plasma for managing calcaneus tendon tendinopathy and plantar fasciitis
López-Gavito E, Gómez-Carlín LA, Parra-Téllez P, Vázquez-Escamilla J.
Acta Ortop Mex. 2011 Nov-Dec;25(6):380-5.

INTRODUCTION:
Non-surgical treatment of Achilles tendinopathies ad plantar fasciitis has shown good results in up to 90% of cases. However, the remaining 10% of patients with these conditions represent a true challenge for the orthopedic surgeon. New technologies for the development of orthobiologic materials make it possible to use platelet-rich plasma (PRP) as an alternative to treat cases that have been refractory to prior treatment and that have a chronicity exceeding 12 months.

MATERIAL AND METHODS:
Prospective, analytical study. Patients with diagnosis of Achilles tendinopathy, plantar fasciitis or both, with a course of more than 12 months, previously treated with non-surgical alternatives, without any clinical improvement. The AOFAS hindfoot scale was used, together with the Visual Analog Scale (VAS) for pain, and photographic documentation at 2, 4, 8 and 12 months after infiltration. A treatment program that included immobilization, NSAIDs, eccentric exercises for the Achilles-calcaneal-plantar system and strengthening of the sural triceps was established. The statistical analysis included measurements of the central trend and scatter with the SPSS 15.

RESULTS:
A sample consisting of 10 patients (12 feet) that met the diagnostic and inclusion criteria was obtained. Mean age at the time of presentation was 43 years (range 23-56), with females being predominant (70%) and 50% laterality for the right and left feet. The initial AOFAS score was 39 (range 28-68) and the VAS score was 9 (range 7-10). By week 16 the AOFAS score had increased to 97 (range 88-99) and the VAS score was 2 (range 1-4). All patients resumed independent gait.

CONCLUSION:
The use of PRP in patients with Achilles tendinopathy and plantar fasciitis is an effective and safe alternative for the management of patients with a poor response to conventional non-surgical treatment. Other non-surgical modalities are recommended besides PRP for the treatment of these patients to achieve appropriate results.
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NewsBot · Jun 7, 2012

This clinical trial was just registered:

Autologous Conditioned Plasma (ACP) for Patients With Plantar Fasciitis

Plantar fasciitis presents clinically as pain in the inner heal, which is the result of degeneration of the plantar fascia, an arch supporting ligament of the foot. It manifests predominantly in those subjected to sustained weight bearing or repetitive pounding activities. Plantar fasciitis is the most common cause of inferior foot pain. Although most cases resolving within 6 months, traditional treatment regiments such as orthotics and physiotherapy are occasionally unsuccessful in treating this limitation leading to chronic symptoms (Neufeld & Cerrato, 2008; Rompe, 2009; Roxas, 2005).

Platelets are central players in clotting, inflammation and the wound healing response. Research has shown the potential of platelet rich plasma to accelerate wound healing in a variety of conditions including maxillo-fascial and plastic surgery, chronic wound healing and orthopaedics. Autologous Conditioned Plasma (ACP) is a novel treatment that may accelerate the healing of injured tissue. Treatment with ACP involves taking a blood sample from the patient, isolating the platelets and injecting them back into that patient at the injury site
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NewsBot · Oct 31, 2012

From latest Podiatry Today:
Platelet-Rich Plasma: Can It Have An Impact For Plantar Fasciitis?

NewsBot · Dec 20, 2012

Platelet-rich plasma injections for chronic plantar fasciitis.
Martinelli N, Marinozzi A, Carnì S, Trovato U, Bianchi A, Denaro V.
Int Orthop. 2012 Dec 19

PURPOSE:
The purpose of this study was to assess the safety and preliminary clinical results of platelet-rich plasma (PRP) injections for treating chronic plantar fasciitis.

METHODS:
Fourteen consecutive patients with chronic plantar fasciitis receiving three injections of PRP into the plantar fascia were assessed 12 months after the procedure. The modified Roles and Maudsley score and a visual analogue scale (VAS) for pain were used to evaluate the clinical results.

RESULTS:
According to criteria of the Roles and Maudsley score, at 12 months of follow-up, results were rated as excellent in nine (64.3 %), good in two (14.3 %), acceptable in two (14.3 %) and poor in one (7.1 %) patient. VAS for pain was significantly decreased from 7.1 ± 1.1 before treatment to 1.9 ± 1.5 at the last follow-up (p < 0.01).

CONCLUSIONS:
In this single-centre, uncontrolled, prospective, preliminary study, results indicate that treating chronic plantar fasciitis with PRP injections is safe and has the potential to reduce pain.
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NewsBot · Feb 9, 2013

PRP Therapy:A Comparative Effective Therapy with Promising Results in Plantar Fascitis
Mukesh Tiwari, Rakesh Bhargava
Journal of Clinical Orthopaedics and Trauma; Available online 4 February 2013

Chronic muscle & tendon injuries are one of the problems which are encountered from human being since last long time.These injuries are generally repetitive strain injuries,commonly found in athletes.There are various treatments which include conservative methods in initial stages to surgery in later stages.On minimal invasive aspect Ultrasound-guided fenestration and tenotomy surgery has been used with good results as a effective treatment of chronic tendinopathies [1, 2]. There are various injectable agents were also researched including simple solutions such as hyperosmolar dextrose [3] (prolotherapy) to complex orthobiologic agents such as bone morphogenic protein [4], but none have achieved uniform success. Platelet rich plasma (PRP) injection has emerged as a treatment alternative for many musculoskeletal conditions. We have done the study on sixty patients to evaluate & compare the effects of platelet rich plasma & steroid injection on patients with planter fascitis. The results at the 1,3 & 6 months were evaluated,which showed the good results with platelet rich plasma in comparison to steroid injections.
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NewsBot · May 7, 2013

Autologous blood injections for chronic plantar fasciitis ‐ a pilot case-series study shows promising results
Wheeler, Patrick
International Musculoskeletal Medicine, Volume 35, Number 1, April 2013 , pp. 3-7(5)

Objectives
Plantar fasciitis is a common condition with a small number of people having symptoms that are challenging to treat. This prospective case series pilot study paper reports the patient outcomes following ultrasound-guided autologous blood injections (ABI) for the treatment of chronic plantar fasciitis symptoms.

Methods and patients
Prospective case-series study of 35 consecutive patients who have undergone ultrasound-guided ABI for recalcitrant plantar fasciitis symptoms in a National Health Service Sports Medicine Clinic in Leicester, UK. Patients treated had suffered with symptoms of plantar fasciitis for an average of more than 4 years pre-ABI. Patients had an average follow-up of 6 months and with a maximum of over 800 days. The outcome measures include visual analogue scale (VAS) for pain, and 7-part patient satisfaction outcome scale.

Results
There was an average reduction of VAS of more than 85% post-ABI for all enrolled patients, increasing to nearly 90% in patients with at least 2 months follow-up data. At the latest follow-up appointment 53% of all patients were pain-free following the ABI procedure, increasing to 71% of patients with at least 2 months of follow-up data.

Discussion
While causality is not proved in this study design, ultrasound-guided ABI appear to be successful in the treatment of recalcitrant plantar fasciitis. Further studies with greater methodological rigour using a control group or alternative interventions should be conducted.
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UKA Pod · May 9, 2013

Can UK Podiatrists legally carry out the PRP procedure?

NewsBot · May 31, 2013

From Podiatry Today:
Point-Counterpoint: Is PRP Beneficial For Chronic Plantar Fasciitis?

NewsBot · Jul 23, 2013

Autologous platelet-rich plasma versus dextrose prolotherapy for the treatment of chronic recalcitrant plantar fasciitis
Eunkuk Kim, Jong Ha Lee
PM&R;19 July 2013

Objective
To determine the efficacy of autologous platelet-rich plasma (PRP) compared with dextrose prolotherapy (DP) in patients with chronic recalcitrant plantar fasciitis (PF)

Design
A single-blinded, randomized, controlled study

Setting
Department of Physical Medicine and Rehabilitation of University Hospital

Participants
Twenty-one patients with a clinical diagnosis of chronic PF confirmed by diagnostic ultrasound (plantar fascia thickness > 4 mm) were randomly assigned to the PRP group (n=10) or the DP group (n=11).

Interventions
Each patient received two injections into the plantar fascia through a peppering technique under ultrasound guidance at an interval of 2 weeks either with 2 ml of autologous PRP or 2 ml of 15% dextrose/lidocaine solution.

Main Outcome Measurements
The outcome measures included the pain, disability, and activity limitation subscales, measured by means of the Foot Functional Index (FFI). The data were collected before the first injection, at 2 weeks (before the second injection), and at the 2- and 6-month follow-ups.

Results
All patients completed the follow-up, with the exception of one patient in the PRP group. The mean FFI total and subcategory score improvements were larger in the PRP group compared with the DP group (improvement with PRP vs. DP – total: 30.4% vs. 15.1%, pain: 29.7% vs. 17.1%, disability: 26.6% vs. 14.5%, activity limitation: 28.0% vs. 12.4%). However, no statistically significant difference was noted at all follow-up intervals. In the pain and disability subcategories, both groups showed significant improvements at the last re-evaluation interval. The PRP group also showed significant improvements in the disability and activity limitation subscales at the second re-evaluation interval.

Conclusions
Each treatment seems effective for chronic recalcitrant PF, expanding the treatment options for patients in whom conservative care failed. Additionally, PRP treatment may lead to a better initial improvement in function compared with DP treatment.
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NewsBot · Aug 3, 2013

The treatment of intractable plantar fasciitis with platelet-rich plasma injection.
Kumar V, Millar T, Murphy PN, Clough T.
Foot (Edinb). 2013 Jul 29.

BACKGROUND:
Whilst most cases of plantar fasciitis can be settled with existing conservative treatment, a few intractable cases can be difficult to resolve. New biologic treatments have been proposed for a variety of soft tissue problems.
OBJECTIVE:
Evaluate the effectiveness of platelet rich plasma (PRP) in chronic cases of plantar fasciitis.
PATIENTS AND METHODS:
Patients with plantar fasciitis not responded to a minimum of 1 year standard conservative management were offered PRP therapy. Injections were performed in theatre as a day case. Roles-Maudsley (RM) scores, Visual Analogue Scores (VAS), AOFAS scores and 'would have injection again' were collated pre-operatively, three and six months.
RESULTS:
Prospective data was collected of 50 heels (44 patients). At six month review, RM score improved from mean 4 to 2 (p<0.001), VAS improved from 7.7 to 4.2 (p<0.001) and AOFAS improved from 60.6 to 81.9 (p<0.001). 28 patients (64%) were very satisfied and would have the injection again. No complications were reported.
CONCLUSION:
In these chronic cases, PRP produce an efficacy rate, approaching 2 out of every 3. The procedure was safe with no reported complications. The authors feel PRP may have some role in treatment, and merits further study with a prospective randomised trial.
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NewsBot · Aug 17, 2013

A study to compare the efficacy of corticosteroid therapy with platelet-rich plasma therapy in recalcitrant plantar fasciitis: A preliminary report
Vijay D. Shetty, Chintan Hegde, Prajyot Jagtap, Suvin Shetty
Foot and Ankle Surgery; Available online 16 August 2013

Background
Plantar fasciitis is one of the commonest, and most frustrating, foot ailments seen in a regular orthopaedic clinic. There are a number of modalities available to treat this condition, of which corticosteroid injection is, perhaps, the most popular. However, recent years have seen an increased interest in the use of platelet-rich plasma (PRP) injections in various clinical situations such as plantar fasciitis.

Methods
We undertook a prospective non-randomized study to compare the efficacy of traditional corticosteroid injection (Steroid group) to PRP injection (PRP group), in a cohort of patients.

Results
We studied both groups of patients before and after the injections using Visual Analogue Score (VAS), the Foot & Ankle Disability Index (FADI) and American Foot and Ankle Score (AFAS). Our study confirms that there is significant clinical improvement in PRP group at three months after the injection.

Conclusion
The use of PRP injection can be an attractive alternative in the treatment of disabling, recalcitrant plantar fasciitis
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NewsBot · Aug 27, 2013

Comparison of Autologous Conditioned Plasma Injection, Extracorporeal Shockwave Therapy, and Conventional Treatment for Plantar Fasciitis: A Randomized Trial
Kelvin Tai Loon Chew et al
PM&R; Available online 22 August 2013

Objective
To evaluate the efficacy of autologous conditioned plasma (ACP) compared to extracorporeal shockwave (ESWT) and conventional treatments for plantar fasciitis.Design: Randomized trial

Setting
Sports medicine center in a tertiary care hospital. Patients: 54 subjects (29-71 years) with unilateral chronic plantar fasciitis with greater than 4 months of symptoms.

Methods
Subjects randomized to three groups: 19 to ACP and conventional treatment (ACP group), 19 to ESWT and conventional treatment (ESWT group), and 16 to conventional treatment alone. Conventional treatment included stretching exercises and orthotics if indicated.

Main Outcome Measurements
Outcomes were pain Visual Analog Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, and ultrasound plantar fascia thickness assessed at baseline pre-treatment and at 1 month, 3 months and 6 months post-treatment.

Results
VAS, AOFAS, and plantar fascia thickness improved in all groups. Significant VAS pain score improvements in the ACP group compared with conventional treatments at the 1st month (P=0.037) and for the ESWT group compared to conventional treatments at the 1st, 3rd and 6th months (P=0.017, P=0.022, P=0.042). AOFAS score improved in the ACP group at the 3rd and 6th months (P=0.004 and P=0.013) and for the ESWT group at the 1st and 3rd months (P=0.011, P=0.003) compared to conventional treatments. Significant improvements in plantar fascia thickness were seen in the ACP group at the 1st and 3rd month compared with conventional treatments (P=0.015, P=0.014) and at the 3rd and 6th months compared to the ESWT group (P=0.019, P=0.027). No adverse events reported.

Conclusions
Treatment of plantar fasciitis with ACP or ESWT plus conventional treatments resulted in improved pain and functional outcomes compared with conventional treatments alone. There was no significant difference between ACP and ESWT in terms of VAS and AOFAS improvements, although the ACP group demonstrated greater reductions in plantar fascia thickness.
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Admin2 · Nov 8, 2013

Evaluation of the results of autologous blood injection in the treatment of refractory heel pain
Muzamil Ahmad Baba, B. A Mir, M. A Halwai, Arshad Bashir, Shakir Rashid, Omar Khursheed, Qazi Manaan
The Foot and Ankle Online Journal 6 (10): 2

Background: Plantar heel pain is one of the most common problems of the foot treated by health care professionals. As the precise etiological diagnosis of a painful heel still remains unknown, this entity remains enigmatic and frustrating to both the physician and the patient. The present study was done to assess the efficacy of autologous blood injection in the treatment of refractory heel pain.
Methodology: Fifty patients (average age of 46.7 years), 18 (36%) males and 32 (64%) females with refractory heel pain of more than 6 months duration underwent autologous blood injection. Patients were clinically evaluated and reviewed with visual analogue scale (VAS) pain scores pre-procedure and post procedure at 6 weeks followed by a final follow up at 6 months.
Results: Our study showed a significant reduction in VAS scores which reduced from a mean score of 8 (range 6-10) to a mean score of 4 (range 2-9) at 6 weeks and 2(range 0-9) at 6 months.
Conclusion: Autologous blood injection can be used as a treatment modality in patients with heel pain.
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NewsBot · Nov 29, 2013

Platelet-Rich Plasma for the Treatment of Chronic Plantar Fasciopathy in Adults
A Case Series
John J. Wilson, MD, MS; Kenneth S. Lee, MD; Andrew T. Miller; Sijian Wang, PhD
Foot Ankle Spec November 27, 2013 1938640013509671

Plantar fasciopathy (PF) is a common source of pain and disability that is often refractory to conservative management. There are no uniformly effective standard-of-care treatments for chronic recalcitrant PF. Corticosteroid injection is considered a viable treatment option when traditional therapies fail, but is limited by suboptimal long-term efficacy and potential adverse effects. Platelet-rich plasma (PRP) is an emerging injection-based treatment for various chronic degenerative soft-tissue diseases. It is postulated to promote native tissue regeneration; however, consistent scientific evidence remains lacking. A prospective case series, including 24 consecutive PF cases, was conducted to report patient-rated pain and disability following PRP injection. Foot and Ankle Ability Measure (FAAM) scores were the primary clinical outcome measure. Foot–Single Assessment Numeric Evaluation (Foot-SANE) scores, Short Form-12 Health Survey version 2 (SF-12v2) questionnaires, and PRP treatment satisfaction surveys were secondary outcome measures. Statistical analysis compared baseline and 32 weeks post-injection time points. Patients receiving PRP injection reported clinically and statistically significant improvement in all outcome measures during this interval. There were no serious adverse events associated with treatment. PRP is considered a safe therapeutic option with the ability to decrease heel pain in patients with chronic PF refractory to appropriate conservative management.
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NewsBot · Jan 14, 2014

Platelet-Rich Plasma Efficacy Versus Corticosteroid Injection Treatment for Chronic Severe Plantar Fasciitis
Raymond Rocco Monto
Foot & Ankle International January 13, 2014 1071100713519778

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.
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NewsBot · Jan 16, 2014

Successful use of platelet-rich plasma for chronic plantar fasciitis.
O'Malley MJ, Vosseller JT2, Gu 3.
HSS J. 2013 Jul;9(2):129-33.

BACKGROUND:
There are limited data on the use of platelet-rich plasma (PRP) for treating chronic plantar fasciitis.
QUESTIONS/PURPOSES:
The purpose of this study was to document the clinical outcomes of patients who were treated with PRP injections for plantar fasciitis to determine the degree to which injections were able to decrease the visual analogue scale (VAS) pain scores and improve patient reported functional scores.
METHODS:
This was a retrospective review of 23 consecutive patients treated with PRP for chronic plantar fasciitis (symptoms lasting over 6 months). Patients returned after 4 weeks for a postinjection follow-up. A second injection was given if significant improvement was not obtained by that time. Postinjection foot and ankle outcome scores (FAOS), 12-item short form health survey (SF-12), and VAS scores were collected at a minimum of 6 months follow-up.
RESULTS:
Thirty injections were given in 23 patients, with one patient lost to follow-up. The mean VAS score improved from 7 to 4. The pain, symptoms, and quality of life subscales of the FAOS and SF-12 significantly improved from preinjection scores. Five patients went on to have endoscopic release of the plantar fascia at an average of 94 days after the last injection (range, 22-314 days). Six patients obtained full resolution of symptoms while the majority of patients were able to forgo surgery due to improvement from the PRP injection.
CONCLUSION:
These results provide preliminary information on the safety and efficiency of PRP injection as treatment for chronic plantar fasciitis.
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NewsBot · Sep 23, 2014

Platelet-rich plasma injections for chronic plantar fasciopathy: a systematic review
F. Franceschi, R. Papalia, E. Franceschetti, M. Paciotti, N. Maffulli, and V. Denaro
Br Med Bull (2014) September 19, 2014

Introduction There is an increasing interest in platelet-rich plasma (PRP) injection as a treatment for chronic plantar fasciopathy (PF). We wished to evaluate the evidence for the use of PRP in PF/fasciitis.

Sources of data We performed a systematic review on the effects of PRP in PF. In June 2014, we searched Medline, Cochrane, CINAHL and Embase databases using various combinations of the commercial names of each PRP preparation and ‘plantar’ (with its associated terms). We only included prospectively designed studies in humans.

Areas of agreement Eight articles met the inclusion criteria, three of them were randomized. All studies yielded a significantly greater improvement in symptoms between baseline and last follow-up assessment. None of the papers recorded major complications.

Areas of controversy Only three randomized studies were identified; none of them had a true controlled group treated with placebo and one of the three studies had a very short (6 week) follow-up. A non-randomized study evaluating PRP versus corticosteroids (CCS) injections, and a randomized controlled trial comparing PRP and dextrose prolotherapy reported no statistical significant differences at 6 months. Most studies did not have a control group and imaging evaluation.

Growing points and areas for research Evidence for the use of PRP in PF shows promising results, and this therapy appears safe. However, the number of studies available is limited and randomized placebo-controlled studies are required. Characterizing the details of the intervention and standardizing the outcome scores would help to better document the responses and optimize the treatment.
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NewsBot · Nov 22, 2014

Full Text:
USE OF PLATELET-RICH PLASMA INJECTION FOR THE TREATMENT OF CHRONIC PLANTAR FASCITIS
Amal Bhattacharya, Rudradeep Banerjee, Subhankar Ghosh
JOURNAL OF EVIDENCE BASED MEDICINE AND HEALTHCARE 2014 November 1 12 Page : 1489-1493

Plantar fascitis is a common cause of heel pain and different treatment options exists. PRP (platelet rich plasma) derived from autologous blood containing high concentration of growth factors help in tissue healing. The use of PRP in the treatment of plantar fascitis is fairly recent an evolving concept. The purpose of our work was to study the effectiveness of PRP in the treatment of chronic plantar fascitis.
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NewsBot · Dec 20, 2014

Is platelet-rich plasma therapy an effective
treatment for plantar fasciitis?

NewsBot · Jan 25, 2015

Comparison of platelet-rich plasma and steroid
injection in the treatment of plantar fasciitis
Ferhat SAY et al
Acta Orthop Traumatol Turc 2014;48(6):673-678

Objective: The aim of this study was to compare the effects of platelet-rich plasma (PRP) and steroid
injections in patients diagnosed with plantar fasciitis.
Methods: A total of 50 patients with chronic plantar fasciitis were included in the study and divided
into 2 groups. In the PRP group (n=25), PRP taken from the patients’ blood was activated using
calcium chloride and injected in a single dose. In the steroid group (n=25), a single dose methylprednisolone
with local anesthetic injection was given. Clinical evaluation was made using the American
Foot and Ankle Score (AFAS) and the visual analog scale (VAS).
Results: No complications were seen in any patients. Mean AFAS was 85.5±4.2 at 6 weeks and
90.6±2.6 at 6 months in the PRP group and 75.3±4.8 and 80.3±4.7, respectively, in the steroid group
(p<0.001). The difference in the mean VAS between the PRP group (2.4±0.8 and 1±0.8) and the steroid
group (4±1.1 and 2.6±0.9) at the 6th week and 6th month was statistically significant (p<0.001).
Changes in AFAS and VAS scores were significantly higher in the PRP group (p<0.001).
Conclusion: The application of PRP appears to be more effective than steroid injection in terms of
pain and functional results in the treatment of chronic plantar fasciitis.
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NewsBot · Feb 1, 2015

Comparison of platelet-rich plasma and steroid injection in the treatment of plantar fasciitis.
Say F, Gürler D, İnkaya E, Bülbül M
Acta Orthop Traumatol Turc. 2014;48(6):667-672. doi: 10.3944/AOTT.2014.13.0142.

Objective: The aim of this study was to compare the effects of platelet-rich plasma (PRP) and steroid injections in patients diagnosed with plantar fasciitis.
Methods: A total of 50 patients with chronic plantar fasciitis were included in the study and divided into 2 groups. In the PRP group (n=25), PRP taken from the patients' blood was activated using calcium chloride and injected in a single dose. In the steroid group (n=25), a single dose methylprednisolone with local anesthetic injection was given. Clinical evaluation was made using the American Foot and Ankle Score (AFAS) and the visual analog scale (VAS).
Results: No complications were seen in any patients. Mean AFAS was 85.5±4.2 at 6 weeks and 90.6±2.6 at 6 months in the PRP group and 75.3±4.8 and 80.3±4.7, respectively, in the steroid group (p<0.001). The difference in the mean VAS between the PRP group (2.4±0.8 and 1±0.8) and the steroid group (4±1.1 and 2.6±0.9) at the 6th week and 6th month was statistically significant (p<0.001). Changes in AFAS and VAS scores were significantly higher in the PRP group (p<0.001).
Conclusion: The application of PRP appears to be more effective than steroid injection in terms of pain and functional results in the treatment of chronic plantar fasciitis.
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NewsBot · Apr 10, 2015

The role of autologous blood injections in the treatment for patients with chronic plantar fasciitis – A case series and longer-term follow-up
Patrick D. Wheeler
International Musculoskeletal Medicine 2015; 0(0),

Objective
To identify outcomes for patients following autologous blood injections for chronic plantar fasciitis symptoms.
Methods
Prospective case series performed by a single clinician in a National Health Service Sports Medicine Department. Patients with recalcitrant symptoms had a single autologous blood injection performed along with a structured rehabilitation programme. Patients were followed up clinically as part of routine care, and those who had previously been discharged, after care was finished, were contacted for a current assessment of symptoms and function.
Results
Sixty-two patients were identified and follow-up data was available for all patients, with a median follow-up of 631 days and with follow-up of at least 1 year for nearly three-quarters of patients. There was an average reduction in pain as assessed by visual analogue score (VAS) of 84%, with 55% of patients reporting themselves as ‘pain-free’ (VAS = 0), and 68% as ‘virtually pain-free’ (VAS 0–1). There were no serious side-effects reported.
Discussion
Autologous blood injections appear to be an appropriate option in the management of patients with chronic plantar fasciitis, although evidence from randomised control trials is still needed to prove causality. There remain a small proportion of patients who do not seem to benefit sufficiently from this procedure and who require alternative treatment options. Further work is required to identify any factors that may be associated with either good or poor response to better tailor individual treatments.
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NewsBot · Aug 13, 2015

Effectiveness of Autologous Blood Injection in Planter Fasciitis
Muhammad Khalid Khan, Samir Khan Kabir
Ophthalmology Update Vol. 13. No. 3, July-September 2015

Background: Planter fasciitis is a painful musculoskeletal condition. Autologous blood injection, one of the conservative
treatments, provides the necessary cellular and biological mediators to induce a healing process.
Objective: To determine the effectiveness of autologous blood injection in patients with planter fasciitis.
Material and Methods: This descriptive cross sectional study was carried out at Department of Orthopedics & Trauma,
Town Teaching Hospital, Peshawar, from June, 2014 to March , 2015 recruiting 54 patients from OPD. In patients with plantar
fasciitis, 2 ml of autologous blood mixed with 2ml of Xylocaine 2% were infiltrated in the planter fascia and effectiveness
of autologous blood injection was determined in terms of improvement in at least one grade of pain on Visual Analogue
Scale at 12 weeks follow up. Data was analyzed with SPSS version10.0.
Results: At 12 weeks follow up, the overall effectiveness of ABI was in 41 (75.92%) patients. After ABI, 19 (35.18%) patients
improved from moderate pain to no pain and mild pain (Grade 0 and 1) while 22 (40.74%) patients with severe pain (grade
3) showed improvement to no pain (grade 0), mild and moderate pain (grade 1 and 2).
Conclusion: Autologous blood injection is very effective to control the pain of planter fasciitis as evident by the decrease in
the baseline grades of VAS at 12 weeks follow up.
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NewsBot · Aug 20, 2015

Platelet-Rich-Plasma injection seems to be effective in treatment of plantar fasciitis: a case series.
van Egmund JC, Breugem SJ, Driessen M, Bruijn DJ.
Acta Orthop Belg. 2015 Jun;81(2):315-20.

Plantar fasciitis is the most common cause of heel pain. Diverse non-operative treatment options are available. The purpose of this study was to determine if a single platelet-rich-plasma injection at the origin of the plantar fascia in patients with plantar fasciitis gives a functional improvement. Patients with plantar fasciitis and failed conservative treatment were included in this retrospective study. Included patients were sent four questionnaires after platelet-rich-plasma injection. Primary outcome is functional improvement, determined by foot function index in which lower scores correlates with a better foot function. A total of 61 feet in 58 patients were included. The median foot function index before treatment was 69.4 and after treatment 31.8, which is a significant decrease. In 80.3% of the patients the foot function index decreased. Therefore platelet-rich-plasma injection seems to be effective in treatment of patients with plantar fasciitis when conservative treatment failed.
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NewsBot · Oct 24, 2015

Local injection of autologous platelet rich plasma compared to corticosteroid treatment of chronic plantar fasciitis patients: A clinical and ultrasonographic follow-up study
Nagwa A. Sherpy et al
The Egyptian Rheumatologist; 19 October 2015

Background
Platelet-rich plasma (PRP) has been gaining popularity as a treatment for plantar fasciitis (PF).

Aim of the work
To compare local autologous PRP and steroid injections both clinically and sonographically within 3-months and also regarding its safety.

Patients and methods
This study was carried out on 50 patients with chronic PF divided into two groups: steroid and PRP groups (n = 25 each). Patients were assessed by visual analog scale (VAS), Foot Health Status Questionnaire (FHSQ) and ultrasonography at 1.5 and 3 months post-injection.

Results
The 50 patients had comparable disease duration (p > 0.5). At 1.5 months post-injection, there was more improvement in the PRP than in the steroid group both clinically (as assessed by the VAS) and ultrasonographically (as regards the echogenicity) (p = 0.008 and p < 0.01, respectively). There was no significant difference between both groups at 3 months. The echogenicity significantly improved at 3 months post-injection within each group (p < 0.0001). Regarding thickness, the difference did not reach significance (p = 0.11, p > 0.05). No significant difference was present between the 2 groups regarding the reduction plantar fascia thickness at 1.5 (p = 0.89) and 3 months (p = 0.64) post-injection. Regarding the safety of both injections, none of our patients in either group developed any significant complications.

Conclusions
We suggest that the PRP injection is a new, readily available, well tolerated and safe choice of therapy for chronic PF and is not inferior to steroid injection in a short term 3 month follow up. Comparing the long-term efficacy both clinically and sonographically is necessary to confirm their sustained effect.
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toomoon · Oct 26, 2015

Why do these studies continue to compare PRP to steroid injection, which has equivocal evidence for efficacy in PHP at best? So we are comparing a therapy that has no evidence to a therapy that has sketchy evidence in the Rx of PRP? Huh??

NewsBot · Nov 7, 2015

Endoscopic plantar fasciotomy versus injection of platelet-rich plasma for resistant plantar fasciopathy
Ahmed Mohamed Ahmed Othman, Islam Hassan Ali Hegazy
Journal of Orthopaedics; 2 November 2015

Background
Resistant plantar fasciopathy is a common orthopedic problem.

Aim
Comparing two different methods of treatment.

Methods
Fifty patients with chronic resistant plantar fasciopathy were divided into two groups. The first included 23 patients treated by endoscopic release of plantar fascia (EPF) and the second included 27 patients treated by injection of platelet-rich plasma (PRP).

Results
In the EPF group, the average VAS improved from 8.28 to 2.35. The average AOFAS improved from 65 to 94. In the PRP group, average VAS improved from 8.22 to 2.9 and the average AOFAS improved from 66 to 92.

Conclusion
Both methods gave comparable results at late follow-up.
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NewsBot · Feb 9, 2016

Effectiveness of Platelet-Rich Plasma in Chronic Severe Plantar Fasciitis: A Prospective Analysis
Thanigai T Sriram, Associate Professor, Deviprasad S, Assistant Professor, Babu MB Sathik, Assistant Professor, Nithin PS, Senior Resident
Indian Journal of Orthopaedics Surgery; Year : 2015, Volume : 1, Issue : 4

Purpose
Chronic plantar fasciitis is a commonly faced problem and can be challenging to treat. The purpose of the study was to prospectively analyze the effectiveness of platelet-rich plasma (PRP) in patients with chronic plantar fasciitis.
Methods
We included 56 patients with unilateral chronic severe plantar fasciitis who underwent a single injection of autologous PRP under ultrasound guidance. The patients were followed up at regular intervals of 3, 6, 12, and 24 months. The results were evaluated with visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale.
Results
The average pretreatment AOFAS score of 56 increased to 96 at 3 months, was 94 at 6 months, and was 92 at 12 months, with a final score of 92 at 24 months. The average pretreatment VAS score of 8.1 decreased to 1.8 at 3 months, was 1.9 at 6 months, and was 2.1 at 12 months, with a final score of 2.0 at 24 months.
Conclusion
From our prospective study, we found that a single injection of PRP is a safe and effective method for the treatment of chronic severe recalcitrant cases of plantar fasciitis.
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NewsBot · Feb 13, 2016

Results of autologous blood injections in patients with plantar fasciitis
Sardar Sohail Afsar, Afsar Khan, Mohammad Idrees.
RMJ. 2016; 41(1): 7-10

Objective: To determine results of autologous blood injection in plantar fascitis.
Methodology: Our descriptive study conducted in Out Patient Department of Pakistan Institute of Medical Sciences, Peshawar and private clinics in Dabgari Garden, Peshawar on 150 patients from January 2012 to December 2014. Patients of either gender between ages 18 to 50 years with more than 12 weeks history of plantar fasciitis symptoms were included. Patients with symptoms for less than 3 months, history of surgery, steroid injection for plantar fasciitis, fracture dislocation, diabetes, and local infection/osteomylitis were excluded from the study. Pain was used to measure the outcome and was measured by using Visual Analogue Scale. Patients were re-assessed after injection at 6, 12 and 24 weeks and pain was scored using Visual Analogue Scale. P value was calculated where necessary and value of <0.5 was considered significant.
Results: Out of 150 patients males were 68 (45.33%) while females were 82 (54.67%). The mean age was 33.61?13.53 (19-49) with a range of 31 years. 110 (73.33%) were from 21-40 years. In 113 (75.33%) right foot while in 37 (24.67%) left foot was involved. On VAS 86(57.33%) had moderate and 64(42.67%) had severe pain. 11(7.33%) were lost during follow up. Pain score on Visual Analogue Scale after autologous blood injection at 6 weeks, 12 weeks and 24 weeks during follow up improved significantly (P value < 0.0001. 88(63.32%) patients had no pain while 40(28.78%) patients had mild pain on Visual Analogue Scale at 24 week follow up. No local or systemic complication noted.
Conclusion: Autologous blood injection shows compatible short term result although long term comparative study is recommended to confirm our results.
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NewsBot · Feb 25, 2016

Autologous whole blood or corticosteroid injections for the treatment of epicondylopathy and plantar fasciopathy? A systematic review and meta-analysis of randomised controlled trials
Mr Konstantinos Tsikopoulos, Mr Alexios Tsikopoulos, Mr Konstantinos Natsis
Physical Therapy in Sport; Article in Press

Highlights
?CSs were marginally superior to AWB in relieving pain on PF at 2-6 weeks.
?AWB provided significantly greater clinical relief in patients with LE at 8-26 weeks.
?Conclusions from this review are limited by the risk of bias and inconsistency.
?High-quality RCTs are needed to explore the long-term efficacy of AWB on PF and LE.
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Objectives
To compare the efficacy of autologous whole blood with that of corticosteroid injections on epicondylopathy and plantar fasciopathy.

Design
Systematic review and meta-analysis.

Methods
The databases of PubMed, Web of Science, CENTRAL, and Scopus were searched up to 6th May 2015. Randomised trials comparing the effects of autologous whole blood and corticosteroid injections on epicondylopathy or plantar fasciopathy were included. Trials exploring the efficacy of platelet-rich plasma were excluded. The primary outcome was pain relief. The secondary outcome included the assessment of composite outcomes. All outcomes were assessed at 2-6 (short-term) weeks, 8-13 (intermediate-term) weeks and 24-26 (medium-term) weeks. Quality assessment was performed with the Cochrane risk of bias tool.

Results
Nine trials were included. For pain relief, there was a statistically significant difference in favour of corticosteroids in the short term (SMD 0.52; 95%CIs 0.18 to 0.86; I2=53%; p<0.01). A statistically significant difference in favour of autologous whole blood was indicated in the medium-term assessment of pain relief on epicondylopathy.

Conclusions
Corticosteroids were marginally superior to autologous whole blood in relieving pain on plantar fasciopathy at 2-6 weeks. Autologous whole blood provided significant clinical relief on epicondylopathy at 8-24 weeks. Conclusions are limited by the risk of bias.
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NewsBot · Feb 27, 2016

Chronic Plantar Fasciitis: Effect of Platelet-Rich Plasma, Corticosteroid, and Placebo.
Mahindra P, Yamin M, Selhi HS, Singla S, Soni A.
Orthopedics. 2016 Feb 24:1-5. doi: 10.3928/01477447-20160222-01

Plantar fasciitis is a common cause of heel pain. It is a disabling disease in its chronic form. It is a degenerative tissue condition of the plantar fascia rather than an inflammation. Various treatment options are available, including nonsteroidal anti-inflammatory drugs, corticosteroid injections, orthosis, and physiotherapy. This study compared the effects of local platelet-rich plasma, corticosteroid, and placebo injections in the treatment of chronic plantar fasciitis. In this double-blind study, patients were divided randomly into 3 groups. Local injections of platelet-rich plasma, corticosteroid, or normal saline were given. Patients were assessed with the visual analog scale for pain and with the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot score before injection, at 3 weeks, and at 3-month follow-up. Mean visual analog scale score in the platelet-rich plasma and corticosteroid groups decreased from 7.44 and 7.72 preinjection to 2.52 and 3.64 at final follow-up, respectively. Mean AOFAS score in the platelet-rich plasma and corticosteroid groups improved from 51.56 and 55.72 preinjection to 88.24 and 81.32 at final follow-up, respectively. There was a significant improvement in visual analog scale score and AOFAS score in the platelet-rich plasma and corticosteroid groups at 3 weeks and at 3-month follow-up. There was no significant improvement in visual analog scale score or AOFAS score in the placebo group at any stage of the study. The authors concluded that local injection of platelet-rich plasma or corticosteroid is an effective treatment option for chronic plantar fasciitis. Platelet-rich plasma injection is as effective as or more effective than corticosteroid injection in treating chronic plantar fasciitis
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NewsBot · May 19, 2016

Effectiveness and relevant factors of platelet?rich plasma treatment in managing plantar fasciitis: A systematic review
Seet Khing Chiew, Thamil Selvee Ramasamy, Farahnaz Amini
Journal of Research in Medical Sciences

Background: Plantar fasciitis (PF) is a common foot complaint, affects both active sportsmen and physically inactive middle age
group. It is believed that PF results from degenerative changes rather than inflammation. Platelet?rich plasma (PRP) therapy has been introduced as an alternative therapy for PF. This study is aimed to systematically review to the effectiveness and relevant factors of PRP treatment in managing PF. Materials and Methods: A search was conducted in electronic databases, including PubMed,Scopus, and Google Scholar using different keywords. Publications in English?language from 2010 to 2015 were included. Two reviewers extracted data from selected articles after the quality assessment was done. Results: A total of 1126 articles were retrieved,but only 12 articles met inclusion and exclusion criteria. With a total of 455 patients, a number of potentially influencing factors on the effectiveness of PRP for PF was identified. In all these studies, PRP had been injected directly into the plantar fascia, with or without ultrasound guidance. Steps from preparation to injection were found equally crucial. Amount of collected blood, types of blood anti?coagulant, methods in preparing PRP, speed, and numbers of time the blood samples were centrifuged, activating agent added to the PRP and techniques of injection, were varied between different studies. Regardless of these variations, superiority of PRP treatment compared to steroid was reported in all studies. Conclusion: PRP therapy might provide an effective alternative to conservative management of PF with no obvious side effect or complication. The onset of action after PRP injection also greatly
depended on the degree of degeneration.
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