EVALUATION OF THE EFFECTIVENESS OF PLATE-RICH CONCENTRATE TREATMENT FOR PLANTAR FASCIA ENTHESOPATHY IN RUNNERS

Abstract

The plantar fascia plays a very important role in the function of the foot during walking and running. It is the most functional element of the medial part of the foot. This disease is one of the most common causes of pain in the heel area in adults. There are many methods and regimens for treating patients with plantar fascia enthesopathy, including non-surgical-orthoses, stretching, taping, iontophoresis, NSAIDs, ESWT, laser, steroid injections, botulinum toxin type A, and surgical-fasciotomy. These methods do not bring high treatment effectiveness. Therefore, it was decided to conduct studies evaluating the effectiveness of an innovative method of treating these diseases. The research involved a group of 54 patients with diagnosed plantar fascia enthesopathy who practiced running sports (at least once a week, over 30 minutes).The first group consisted of 34 persons who were treated with a PRP injection and a specific rehabilitation program. The second group consisted of 20 people as a control group with diagnosed plantar fascia enthesopathy, matched for sex and age, subjected to an identical rehabilitation protocol, and not treated with PRP. The effectiveness of the treatment of patients with the use of a platelet-rich concentrator was assessed experimentally. The study consisted in monitoring a selected group of patients with a disease for which the proposed therapy was applied. The control group consisted of people with the same diseases without the study therapy. Pain sensations were recorded according to VAS scale and quality of life -EQ-5D, percentage index of the foot function index, limb stability index. The obtained statistical data indicate a downward trend in all parameters of the results obtained after the therapy in relation to the data from before the therapy, which proves the effectiveness of the studied therapy. For the parameter defining pain when touching in the group studied before the therapy, the median value was 4, and after the therapy the value was 0. The downward trend was also maintained with the percentage value of the foot function index (sum_FFI_%) at the value of 42% before the therapy, reaching 1% after the therapy. In the control group, the values also maintained a downward trend in the value of the function index was obtained at the level of 44% with the result after treatment at the level of 9%. Among the treatments currently in use for plantar fascia enthesopathy, there is no single most effective method. The therapeutic method presented in the study showed statistically better results than commonly used therapies for this disease. The use of therapy with an autogenous platelet-rich concentrator in the treatment of plantar fascia enthesopathy with a selected rehabilitation program shows a significant advantage over all natural methods. It gives good effectiveness in healing this type of diseases, and in combination with rehabilitation, it brings measurable therapeutic benefits.