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Study Papers | Orthopaedic Surgery | India | Volume 12 Issue 1, January 2023
A Comparative Study between Single Dose Intralesional Corticosteroid and PRP Injection in Chronic Plantar Fascitis - A Long Term Follow-Up Study
Dr. R. Shahnawaz Hussain | Dr. Yannam Maniraj Chowdary
Abstract: Background: Corticosteroids exerts its anti-inflammatory effect by lipocortin-1 synthesis. Lipocortin-1 inhibits phospholipase A2 thereby preventing the formation of prostaglandins and leukotreines which are primary mediators of inflammation. It also inhibits various inflammatory events like white blood cell migration, chemo taxis, phagocytosis. Platelet rich plasma (PRP) is defined as a volume of the plasma fraction of autologous blood having a platelet concentration above baseline. Platelets contain bioactive proteins responsible for attracting macrophages, mesenchymal stem cells, and osteoblasts which not only promote removal of necrotic tissue, but also enhance tissue regeneration injection is used to introduce platelets into tissue to stimulate a supra-physiologic release of growth factors in an attempt to start healing in chronic injuries and reduce pain. Treatment options for plantar fasciitis range from simple analgesics to plantar fascia release surgeries. The beneficial effects by local corticosteroid injection were known for long time. PRP injection was proposed for chronic plantar fascitis due to their high growth factor composition. Patients and methods: The present study was conducted in Department of Orthopaedics at GSL Medical College and general hospital from December 2020 to may 2022. In this series, fifty patients having chronic plantar fasciitis were treated with corticosteroid and PRP injection. The results were evaluated prospectively to compare the efficacy of both the procedures. First group of twenty five patients received an injection of corticosteroid and the second group of twenty five patients received an injection of PRP. Following random selection, patients were chosen after they met the study's inclusion criteria. The patients were followed at 3, 6 and 12 months post-injection and the pain and activity level noted. The outcome was based on our scoring system based on the pain status and the activity level at the end of 3 months, 6 months and 12 months. Results: Both groups initially performed well. The patients were followed up at 3, 6, and 12 months interval and were analyzed with the scoring systems (American Orthopedic Foot and Ankle Society [AOFAS], visual analog scale (VAS). The average preinjection mean AOFAS score at 3 months after treatment in the steroid group was 45.10 and improved to 85.10 and in the PRP group was 40.05 and improved to 92.10. However, the steroid group scores degraded with a drop in the AOFAS rating to 72.40 at 6 months and 60.30 at 12 months after treatment. In contrast, the PRP group scores remained high with AOFAS scores of 88.50 at 6 months and 85.20 at 12 months after treatment. The average preinjection VAS score at 3 months after treatment in the steroid group was 8.6 improved to 3.2 and in the PRP group was 8.8 and improved to 2.8. However, the steroid group VAS scores degraded to 6.2 at 12 months, the PRP group VAS score was 4.2 at 12 months, which is better than steroid group. Conclusion: PRP showed superior results compared to corticosteroid group in VAS and AOFAS scores in long term follow up.
Keywords: PRP, plantar fascitis, corticosteroid
Edition: Volume 12 Issue 1, January 2023,
Pages: 75 - 79