Abstract
Introduction
Whilst most cases of plantar fasciitis can be resolved with existing conservative established treatment options, a few intractable cases can be difficult to resolve. New biologic treatments have been proposed for a variety of soft tissue tendon problems. We evaluated the results of PRP in the treatment of recalcitrant chronic cases of plantar fasciitis.
Methods
Patients with plantar fasciitis that had not responded to a minimum of 8 months standard conservative management (eccentric stretching, physiotherapy, cortisone injection, night splints) were offered PRP therapy. The injection into the tender spot at the proximal plantar fascial insertion was performed in theatre as a day case. Roles Maudsley (RM) scores, Visual analogue scores (VAS) for pain, AOFAS scores and ‘would have injection again’ were collated pre-operatively, at three and six months.
Results
Prospective data was collected on 39 patients (44 heels – 15 males, 24 females; mean age 51 years, range 25–79 years). No complications were noted. At six months review RM score improved from 3.8 to 2.5 (p<0.001), VAS improved from 7.7 to 4.2 (p<0.001) and AOFAS improved from 61 to 82 (p<0.001). 21 patients had complete relief of symptoms on 3 months review. 25 patients were very satisfied with the clinical improvement and would have the injection again. Whilst there was a slight improvement in scores from 3 to 6 months, this was not significant. 3 patients with bilateral injections on the same sitting did not improve, though 2 patients with bilateral injections on separate sittings did improve.
Conclusion
In this series of chronic intractable cases, PRP injection produced a 64% satisfaction rate from patients. The procedure was safe with no reported complications. The authors feel PRP for plantar fasciitis may have some role in treatment and merits further study with a prospective randomised trial.
