Archives of Orthopaedic and Trauma Surgery

, Volume 132, Issue 8, pp 1065–1070 | Cite as

Platelets rich plasma for treatment of chronic plantar fasciitis

  • Ehab Mohamed Selem Ragab
  • Ahmed Mohamed Ahmed Othman
Orthopaedic Surgery

Abstract

Background

Plantar fasciitis is a common cause of heel pain in adults. Many treatment options exist. Platelets rich plasma (PRP) is derived from autologous blood and contains high concentration of growth factors necessary for tissue healing. The use of PRP in the treatment of plantar fasciitis is a fairly recent and evolving concept. The purpose of our work was to study the effectiveness of PRP treatment for chronic plantar fasciitis.

Materials and methods

Between February 2010 and June 2011, 25 patients with chronic plantar fasciitis with a mean age of 44 years were treated by PRP injection and included in this prospective study. All patients were assessed for the pain on Visual Analogue Scale (VAS) pre-injection and post-injection. Using ultrasound, the thickness of the plantar fascia was measured prior to the injection of PRP and at each visit of follow-up after injection. The mean follow-up was 10.3 months.

Results

Using a visual analog pain scale, the average pre-injection pain in patients of was 9.1 (range 8–10). Prior to injection, 72 % of patients had severe limitation of activities, and 28 % of patients had moderate limitation of activities. Average post-injection pain decreased to 1.6. Twenty-two patients (88 %) were completely satisfied, two patients (8 %) were satisfied with reservations, and one patient (4 %) was unsatisfied with using the visual analog scale. Fifteen patients (60 %) had no functional limitations post-injection and eight patients (32 %) had minimal functional limitations. Two patients (8 %) had moderate functional limitations post-injection. Twenty PRP injections. Ultrasonography, we noted significant changes not only in thickness but also in the signal intensity of the plantar fascia after PRP injection. None of our patients experienced any complications from PRP injection at the end of follow-up period.

Conclusion

Injection of PRP is safe and doesn’t affect the biomechanical function of the foot. Our successful early findings with injection of PRP indicate that this may become a very commonly used modality in treating this difficult condition.

Keywords

Plantar fasciitis Platelets rich plasma Functional limitation Ultrasound 

References

  1. 1.
    Khan KM, Cook JL, Taunton JE, Bonar F (2000) Overuse tendinosis, not tendonitis; a new paradigm for a difficult clinical problem (part1). Phys Sports Med 28:172–175Google Scholar
  2. 2.
    Barrett SL, Robert OM (1999) Plantar fasciitis and other causes of heel pain. Am Fam Physician 59(8):2200–2206PubMedGoogle Scholar
  3. 3.
    Lynch DM, Goforth WP, Martin JE, Odom RD, Preece CK, Kotter MW (1998) Conservative treatment of plantar fasciitis. A prospective study. J Am Podiat Med Assoc 88:375–380Google Scholar
  4. 4.
    Craig CY, Darin SR, Mark WN (2001) Treatment of plantar fasciitis. Am Fam Physician 63(1):467–474Google Scholar
  5. 5.
    Urovitz EP, Urovitz AB, Urovitz EB (2008) Endoscopic plantar fasciotomy in the treatment of chronic heel pain. Can J Surg 51(4):281–283PubMedGoogle Scholar
  6. 6.
    Sampson S, Gerhordt M, Mandelbaum B (2008) Platelet rich plasma injection for MS injuries. A Curr Rev MS Med 1(3–4):165–174Google Scholar
  7. 7.
    Sabir N, Demirlenk S, Yagci B, Karabulut N, Cubukeu S (2005) Clinical utility of sonography in diagnosing plantar fascitis. J Ultrasound Med 24(8):1041–1048PubMedGoogle Scholar
  8. 8.
    Foster TE, Puskas BL, Mandebaum BR, Gerhardt MB, Rodeo SA (2009) Platelet-rich plasma: from basic science to clinical application. Am J Sports Med 1112–1115Google Scholar
  9. 9.
    Hammond JW, Hinton RY, Curl LA, Muriel JM, Lovering RM (2009) Use of autologus platelet-rich plasma to treat muscle strain injuries. Am J Sports Med 37(11):1135–1142PubMedCrossRefGoogle Scholar
  10. 10.
    Peerboms JC, Sluimer J, Bruihn DJ, Gosens T (2010) Positive effect of autologus platelet-rich plasma concentrate in lateral epicondylitis in double blind randomized controlled trail: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med 38(11):2100–2111Google Scholar
  11. 11.
    Leeuwen MT, Zwerver J, Andkker-Scheek I (2009) Extracorporeal shockwave therapy for patellar tendinopathy: a review of the literature. Br J Sports Med 43:163–168PubMedCrossRefGoogle Scholar
  12. 12.
    Peerbooms JC, Laar WV, Faber F, Schuller HM, Hoeven HV, Gosens T (2010) Use of platelet rich plasma to treat plantar fasciitis: design of a multi centre randomized controlled trial. BMC Musculoskelet Disord 11:69–74Google Scholar
  13. 13.
    Barrett SL, Erredge SE (2004) Growth factors for chronic plantar fasciitis. Podiatry Today 17:37–42Google Scholar
  14. 14.
    Marx R, Carlson E, Eichstedt R (1998) Platelet rich plasma: growth factor enhancement for bone and grafts. Oral Surg Oral Med Oral Pathol 85(6):643–646Google Scholar
  15. 15.
    Gruber P, Varga E, Fisher M (2002) Platelets stimulate proliferation of bone cells: involvement of platelet derived growth factor, microparticles, and membranes. Clin Oral Implants Res 13:529–535PubMedCrossRefGoogle Scholar
  16. 16.
    David JS (2011) Current concepts for the use of PRP in the ankle and foot. Clin Podiatric Med Surg 28(1):155–170CrossRefGoogle Scholar
  17. 17.
    Kane D, Greaney T, Shanahan M, Duffy V, Bresnihan B, Gibney R, FitzGerald O (2001) The role of ultrasonography in the diagnosis and management of idiopathic plantar fasciitis. Rheumatology 40(9):1002–1008PubMedCrossRefGoogle Scholar
  18. 18.
    Tatli Y, Kapasi S (2009) The real risks of steroid injections for plantar fasciitis, with a review of conservative therapies. Curr Rev Musculoskeletal Med 2:3–9CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Ehab Mohamed Selem Ragab
    • 1
  • Ahmed Mohamed Ahmed Othman
    • 2
  1. 1.Faculty of MedicineAl-Azhar UniversityCairoEgypt
  2. 2.Faculty of MedicineEl-Minia UniversityEl-MiniaEgypt

Personalised recommendations