Application of platelet rich plasma in the treatment of pain syndrome in patients with plantar fasciitis
DOI:
https://doi.org/10.15674/0030-59872019185-90Keywords:
platelet-rich plasma, foot, plantar fasciitis, plantar aponeurosisAbstract
Objective: to analyze the results of the injection of plateletrich plasma (PRP) and prolonged-acting corticosteroids in patients with plantar fasciitis (PF).
Methods: 43 patients were examined (55 feet) with pain syndrome of PF. There were women 29, men — 14, average age (44 ± 1.41) years, average duration of the pain syndrome (3.5 ± 0.36) months. Together with the complex of conservative treatment for patients we prescribed locally injections: in group I (27 patients) — once 1 ml of betamethasone, in II group (16 patients) — PRP (2 ml three times with an interval of 7 days in the region of enthesis). The standard PRP method was used. The pain syndrome was evaluated with the help of VAS before, after 1, 3 and 6 months after treatment. Thickness of plantar aponeurosis (PA) was measured with sonography before and in 6 months after treatment.
Results: the average level of pain syndrome before the injections in the both groups were almost identical and amounted to (7.2 ± 0.17) and (7.3 ± 0.23) points, respectively. In a month after the injection in the Ist group, the pain syndrome significantly decreased to (3.5 ± 0.12) points, which confirms fast analgesic effect of manipulation. In the IInd group, the indicators of pain decreased to (4.6 ± 0.17) points. By 6 months the results were almost identical in both groups of patients. Thickness of PA before treatment was equal in the group І (6.62 ± 0.08) mm, in ІІ — (6.81 ± 0.1) mm, so there was no difference between them. After 6 months the thickness of PA was equally reduced in both groups: in the Ist — to (4.49 ± 0.07) mm, in the IInd — to (4.42 ± 0.09) mm, which is objective criterion for the positive therapeutic effect of both methods of treatment.
Conclusions: injections of PRP and prolonged-action corticosteroids provide the same positive results in the treatment of pain syndrome in patients with PF. Effect of corticosteroids is fast, but their use is limited due to a number of complications. The introduction of PRP helps to reduce pain syndrome and to normalize thickness of PA.
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