Platelet-rich plasma as a treatment for plantar fasciitis: A meta-analysis of randomized controlled trials.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors report no conflicts of interest. 20. Orthop J Sports Med. 2020 Apr 27;8(4):2325967120915704. doi: 10.1177/2325967120915704. eCollection 2020 Apr. Platelet-Rich Plasma Versus Corticosteroids for Plantar Fasciitis: A Systematic Review of Randomized Controlled Trials. Hurley ET(1)(2), Shimozono Y(1)(3), Hannon CP(4), Smyth NA(5), Murawski CD(6), Kennedy JG(1). Author information: (1)NYU Langone Health, New York, New York, USA. (2)Royal College of Surgeons in Ireland, Dublin, Ireland. (3)Kyoto University Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto, Japan. (4)Rush University Medical Center, Chicago, Illinois, USA. (5)Cleveland Clinic Florida, Miami, Florida, USA. (6)University of Pittsburgh, Pittsburgh, Pennsylvania, USA. BACKGROUND: Plantar fasciitis is the most common cause of plantar heel pain. Several recent randomized control trials (RCTs) have been published comparing the use of platelet-rich plasma (PRP) and corticosteroids (CSs) for the treatment of plantar fasciitis. PURPOSE: To perform a systematic review of RCTs to compare whether PRP or CS injections result in decreased pain levels and improved patient outcomes in the treatment of plantar fasciitis. STUDY DESIGN: Systematic review; Level of evidence, 1. METHODS: Medline, EMBASE, and the Cochrane Library were screened according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify RCTs comparing PRP and CS injections for plantar fasciitis. The visual analog scale (VAS) pain scores and the American Orthopaedic Foot and Ankle Society (AOFAS) scores were compared between groups at 1, 1.5, 3, 6, and 12 months, where possible. Statistical analysis was performed using RevMan, and P < .05 was considered to be statistically significant. RESULTS: A total of 9 RCTs were identified comparing 239 patients with PRP with 240 patients with CS injections. At the follow-up time points, including 1-1.5, 3, 6, and 12 months, there were statistically significant differences in VAS scores in favor of PRP (P = .004, P < .00001, P < .00001, and P < .00001, respectively). At 1 and 3 months, there was no difference in AOFAS scores (P = .76 and P = .35, respectively). However, at 6 and 12 months, there was a difference in AOFAS scores in favor of PRP (P < .00001 and P < .00001, respectively). CONCLUSION: In patients with chronic plantar fasciitis, the current clinical evidence suggests that PRP may lead to a greater improvement in pain and functional outcome over CS injections. © The Author(s) 2020. DOI: 10.1177/2325967120915704 PMCID: PMC7222276