Is Platelet-Rich Plasma Injection Combined with Microtenotomy More Effective Than Corticosteroid Injection in Chronic Plantar Fasciitis?
DOI:
https://doi.org/10.25759/spmfr.539Keywords:
plantar fasciitis, platelet-rich plasma, corticosteroids, dry needling, ultrasoundAbstract
Introduction: Chronic plantar fasciosis (PF) is the leading cause of hindfoot pain in adults, and its treatment is often challenging. This study aims to compare the effectiveness of ultrasound-guided platelet-rich plasma (PRP) injection combined with plantar fascia fenestration versus ultrasound-guided corticosteroid injection in the treatment of chronic PF refractory to conservative management.
Materials and Methods: This was a prospective, comparative, open-label study conducted at a tertiary hospital between January and May 2024. Twenty participants were included and divided into two groups: Group 1 (n=10) underwent ultrasound-guided PRP injection with plantar fascia fenestration, while Group 2 (n=10) received ultrasound-guided corticosteroid injection. Pain was assessed using the Numerical Pain Rating Scale (NPRS), and functionality was evaluated using the Foot and Ankle Ability Measure (FAAM) questionnaire at baseline and post-procedure (1 week, 1 month, and 3 months).
Results: One week after the procedure, NPRS scores were 6.6±2.4σ in Group 1 and 2.3±3.1σ in Group 2. At three months, NPRS scores decreased to 3.3±3.3σ in Group 1, while Group 2 showed an increase to 5.0±3.2σ. Regarding FAAM, at one month post-procedure, Group 1 showed a score of 75.1%±16.2σ, while Group 2 had 90.6%±14.8σ. At three months, FAAM scores continued to improve in Group 1, reaching 83.7%±18.8σ, whereas Group 2 experienced a decline to 67.9%±18.5σ.
Discussion: Corticosteroids provided faster short-term improvement in pain and function compared to PRP combined with plantar fascia fenestration. However, the latter demonstrated a trend toward more sustained pain and functional improvement over time.
Conclusion: PRP injection combined with plantar fascia fenestration showed a trend toward better pain and functional outcomes at three months post-procedure compared to corticosteroid injection. This study suggests that plantar fascia fenestration with PRP injection is a safe and effective therapeutic option for refractory plantar fasciosis.
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