The Use of Platelet Rich Plasma in Chronic Plantar Fasciitis

Abstract Background: Chronic plantar fasciitis is the most common cause of foot complaints making up to 11-15% of the foot symptoms requiring professional care among adults. Also, it is a common problem that affects sport participants as well as inactive middle-aged individuals. Many modalities of treatment were prescribed to relieve the symptoms such as rest, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), brac-ing, physical therapy and corticosteroid injection. Newer treatment modalities have been tried, such as extracorporeal shock wave treatment, iontophoresis, and injection of botulism toxin. In case of lack of response to conservative treatment, the last resort is surgery with the primary objective of relieving pain. One novel treatment strategy is the use of local injection of platelet rich plasma. These platelets release a large propor-tion of biologically active growth factors that are thought to accelerate and improve the regeneration and healing process. Aim of Study: This study is designed to be a prospective study, aiming to evaluate the clinical outcome of patients who were diagnosed to have chronic plantar fasciitis and treated with platelet rich plasma local injection. Patients and Methods: The study was conducted on 40 patients (16 males-24 females) from September 2017 to August 2018 with chronic planter fasciitis attending the outpatient clinic of the Orthopedic Department of Tanta University Hospitals. Their ages ranged from 30 to 57 years with mean age of 42.17. All patients had inferior heel pain that is usually worse with their first steps in the morning or after a period of inactivity, with maximal tenderness over the antero-medial aspect of the inferior heel and not responding to conservative treatment. Patients were treated by local injection of platelet rich plasma at maximal tender point of the heel. They were followed-up after one month, two months, three months and six months using Visual Analogue Scale, Roles and Maudsley Score, and American Orthopedic Foot and Ankle Society Score. Results: All patients were successfully followed-up for 6 month. According to VAS of pain, the mean VAS of pain had improved from 8.03±1. 12 pre-injection to 2.28-}1.18 post injection. According to Roles and Maudsley score, 9 patients with excellent results, 22 patients with good results, 7 patients with accepted results and 2 patients with poor results. Accord-ing to AOFAS, the mean of AOFAS had improved from 49.80-} 8.93 pre-injection to 82.0-}8.94 post injection. The final end results were satisfactory in 31 patients out of 40 and 9 patients ended by unsatisfactory results. There were no complications reported during follow-up of the cases.