Musculoskeletal Ultrasound Changes in Chronic Plantar Fascia after Treatment with Platelet Rich Plasma Compared to Steroid

Abstract

Background. Chronic plantar fasciitis (PF) is a common orthopedic condition that can demonstrate hard to effectively treat. In this study, platelet-rich plasma (PRP), a concentrated bioactive blood segment wealthy in cytokines and growth factors, was compared to steroid injection in the treatment of Chronic plantar fasciitis resistant to traditional non-operative management. Objective. To compare the effect of ultrasound-guided (US guided) injection of platelets rich plasma (PRP) with that of corticosteroid injection to treat patients with chronic PF. Methods. Patients with PF (n = 98) were assigned to receive either PRP or cortico-steroid US-guided injection with double blind randomized. The visual analogue scale (VAS) at baseline evaluated the pain level, three and twelve weeks after injection. Results. In both corticosteroid and PRP injected groups, the average VAS heel pain scores and the mean its impact on quality of life were evaluated using the Manches-ter-Oxford Foot Questionnaire (MOxFQ) scores were statistically lower compared with the pre-treatment scores (P < 0.001). The improving symptoms in the corticoste-roid group at the beginning were better and then decreased after 12 weeks; still the differences were significant, while in the PRP group symptoms progressively improved. Conclusions. The current study results revealed that both PRP injection and cortico-steroid injection are modalities for treatment of plantar fasciitis. PRP preparation is more powerful and strong than cortisone injection for the treatment of chronic plantar fasciitis, with less side effects and precautions. Study registration. The study was registered in clinicalTrials.gov (NCT05339542).