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Sharma R, Chaudhary NK, Karki M, Sunuwar DR, Singh DR, Pradhan PMS, Gyawali P, Duwal Shrestha SK, Bhandari KK. Effect of platelet-rich plasma versus steroid injection in plantar fasciitis: a randomized clinical trial. BMC Musculoskelet Disord 2023; 24:172. [PMID: 36882804 PMCID: PMC9989576 DOI: 10.1186/s12891-023-06277-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Plantar fasciitis (PF) is a common orthopaedic problem, with heel pain worsening the quality of life. Although steroid injection is often used if the conservative treatment fails, Platelet-Rich Plasma (PRP) injection is gaining popularity due to its safety and long-lasting effect. However, the effect of PRP versus steroid injection in PF has not been studied yet in Nepal. Therefore, this study aimed to assess the effect of PRP compared with steroid injection in the treatment of PF. METHODS This study was a single-center, hospital-based, open-label, parallel-group randomized clinical trial to compare the effect of PRP injection with steroid injection in plantar fasciitis between August 2020 and March 2022. A total of 90 randomly selected participants aged 18 to 60 years suffering from plantar fasciitis with failed conservative treatment were intervened. The American Orthopaedic Foot and Ankle Society (AOFAS) and the Visual Analog Scale (VAS) scoring system were used to evaluate functional mobility and pain before and after the intervention for three and six months, respectively. Statistical analyses were performed using a Student's two-sample t-test. P-value < 0.05 was considered statistically significant. RESULTS The PRP injection showed a better outcome than the steroid injection in six months follow-up. The mean (± SD) VAS score was significantly decreased in the PRP group (1.97 + 1.13) than in the steroid group (2.71 ± 0.94) with the group difference of -0.73 (95% CI: -1.18 to -0.28) at six months. Similarly, there was a significant increase in the AOFAS scores in the PRP group (86.04 ± 7.45) compared to the steroid group (81.23 ± 9.60) at six months of follow-up with a group difference of 4.80 (95% CI: 1.15 to 8.45). There was also a significant reduction of plantar fascia thickness in the PRP group compared to that of the steroid group (3.53 ± 0.81 versus 4.58 ± 1.02) at six months of follow-up with the group difference of -1.04 (95% CI: -1.44 to -0.65). CONCLUSION The PRP injection showed better outcomes than steroid injection in plantar fasciitis treatment over the course of six months. Further research with a larger population and longer follow-up than six months is needed to generalize the findings and their long-term efficacy. TRIAL REGISTRATION NCT04985396. First registered on 02 August 2021. ( https://clinicaltrials.gov/ct2/show/NCT04985396 ).
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Affiliation(s)
| | | | | | - Dev Ram Sunuwar
- Department of Nutrition and Dietetics, Nepal Armed Police Force Hospital, Kathmandu, Nepal
| | - Devendra Raj Singh
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Pranil Man Singh Pradhan
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Tribhuvan, Nepal
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Kotb SY, Sherif NM, Saleh HA, Ahmed SF, Sakr HM, Taeimah MO. The role of intra-articular injection of autologous platelet-rich plasma versus corticosteroids in the treatment of synovitis in lumbar facet joint disease. Saudi Med J 2022; 43:1200-1208. [PMID: 36379530 PMCID: PMC10043910 DOI: 10.15537/smj.2022.43.11.20220449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES To compare the efficacy between platelet-rich plasma (PRP) and corticosteroids (CS) in improving magnetic resonance imaging (MRI)-detected synovitis in correlation with clinical complaints among patients with lumbar facet joint (FJ) disease. METHODS This study was carried out at Eldemerdash Hospital, Cairo, Egypt between September 2019 and January 2021. A prospective, randomized, comparative, single blinded study included 30 patients with lumbar FJ disease, divided into 2 equal groups, received PRP and CS injections. Patients were comparatively assessed before and after the intervention according to number of tender lumbar FJs, maximum active lumbar extension range of motion, LBP visual analogue score, LBP functional disability questionnaires and MRI lumbar FJ detected synovitis and their grading. RESULTS Both groups showed a significant improvement in all mentioned parameters at follow-up after 3 months. However, PRP injections promoted better performance in terms of MRI synovitis grade in all lumbar FJ levels compared to CS injections. CONCLUSION Both PRP and CS injections were effective in improving MRI-detected FJ synovitis while concurrently improving all examined parameters at follow-up after 3 months. However, PRP promoted better improvement in MRI-detected synovitis grade, suggesting that it may be a better treatment option for longer duration efficacy.TRN: NCT04860531- 1/3/2021.
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Affiliation(s)
- Shahdan Y. Kotb
- From the Department of Physical Medicine, Rheumatology and Rehabilitation (Kotb, Sherif, Saleh, Ahmed); from the Department of Radiodiagnosis (Sakr); and from the Department of Anesthesiology, Intensive Care and Pain Management (Taeimah), Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Nahed M. Sherif
- From the Department of Physical Medicine, Rheumatology and Rehabilitation (Kotb, Sherif, Saleh, Ahmed); from the Department of Radiodiagnosis (Sakr); and from the Department of Anesthesiology, Intensive Care and Pain Management (Taeimah), Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Hala A. Saleh
- From the Department of Physical Medicine, Rheumatology and Rehabilitation (Kotb, Sherif, Saleh, Ahmed); from the Department of Radiodiagnosis (Sakr); and from the Department of Anesthesiology, Intensive Care and Pain Management (Taeimah), Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Sahar F. Ahmed
- From the Department of Physical Medicine, Rheumatology and Rehabilitation (Kotb, Sherif, Saleh, Ahmed); from the Department of Radiodiagnosis (Sakr); and from the Department of Anesthesiology, Intensive Care and Pain Management (Taeimah), Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Hossam M. Sakr
- From the Department of Physical Medicine, Rheumatology and Rehabilitation (Kotb, Sherif, Saleh, Ahmed); from the Department of Radiodiagnosis (Sakr); and from the Department of Anesthesiology, Intensive Care and Pain Management (Taeimah), Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Mohamed O. Taeimah
- From the Department of Physical Medicine, Rheumatology and Rehabilitation (Kotb, Sherif, Saleh, Ahmed); from the Department of Radiodiagnosis (Sakr); and from the Department of Anesthesiology, Intensive Care and Pain Management (Taeimah), Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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