Positive effect of platelet-rich plasma on pain in plantar fasciitis: A double-blind multicenter randomized controlled trial

Joost C Peerbooms*, Paul Lodder, Brenda L den Oudsten, Kamiel Doorgeest, Hans M Schuller, Taco Gosens

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background: 

When nonoperative treatment for chronic plantar fasciitis fails, often a corticosteroid injection is given. Corticosteroid injection gives temporary pain reduction but no healing. Platelet-rich plasma (PRP) has proven to be a safe therapeutic option in the treatment of tendon, muscle, bone, and cartilage injuries.

Purpose: 

To determine the effectiveness of PRP as compared with corticosteroid injections for chronic plantar fasciitis.

STUDY DESIGN: Randomized controlled trial; Level of evidence, 1.

Methods: 

Patients with chronic plantar fasciitis were allocated to have steroid injection or PRP. The primary outcome measure was the Foot Function Index (FFI) Pain score. Secondary outcome measures were function, as scored by the FFI Activity, FFI Disability, and American Orthopaedic Foot & Ankle Society, and quality of life, as scored with the short version of the World Health Organization Quality of Life (WHOQOL-BREF). All outcomes were measured at baseline and at 4, 12, and 26 weeks and 1 year after the procedure.

Results: 

Of the 115 patients, 63 were allocated to the PRP group, of which 46 (73%) completed the study, and 52 were allocated to the control group (corticosteroid injection), of which 36 (69%) completed the study. In the control group, FFI Pain scores decreased quickly and then remained stable during follow-up. In the PRP group, FFI Pain reduction was more modest but reached a lower point after 12 months than the control group. After adjusting for baseline differences, the PRP group showed significantly lower pain scores at the 1-year follow-up than the control group (mean difference, 14.4; 95% CI, 3.2-25.6). The number of patients with at least 25% improvement (FFI Pain score) between baseline and 12-month follow-up differed significantly between the groups. Of the 46 patients in the PRP group, 39 (84.4%) improved at least 25%, while only 20 (55.6%) of the 36 in the control group showed such an improvement (P = .003). The PRP group showed significantly lower FFI Disability scores than the control group (mean difference, 12.0; 95% CI, 2.3-21.6).

Conclusion: Treatment of patients with chronic plantar fasciitis with PRP seems to reduce pain and increase function more as compared with the effect of corticosteroid injection.


Original languageEnglish
Pages (from-to)3238-3246
JournalThe American Journal of Sports Medicine
Volume47
Issue number13
DOIs
Publication statusPublished - 2019

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Platelet-Rich Plasma
Adrenal Cortex Hormones
Orthopedics
Muscles
Wounds and Injuries

Keywords

  • CORTICOSTEROID INJECTION
  • DIAGNOSIS
  • EFFICACY
  • FOOT FUNCTION INDEX
  • RUPTURE
  • THERAPY
  • VALIDATION
  • corticosteroids
  • function
  • pain
  • plantar fasciitis
  • platelet-rich plasma

Cite this

@article{79f13ad625874cc1b0b944a8868f1833,
title = "Positive effect of platelet-rich plasma on pain in plantar fasciitis: A double-blind multicenter randomized controlled trial",
abstract = "Background: When nonoperative treatment for chronic plantar fasciitis fails, often a corticosteroid injection is given. Corticosteroid injection gives temporary pain reduction but no healing. Platelet-rich plasma (PRP) has proven to be a safe therapeutic option in the treatment of tendon, muscle, bone, and cartilage injuries.Purpose: To determine the effectiveness of PRP as compared with corticosteroid injections for chronic plantar fasciitis.STUDY DESIGN: Randomized controlled trial; Level of evidence, 1.Methods: Patients with chronic plantar fasciitis were allocated to have steroid injection or PRP. The primary outcome measure was the Foot Function Index (FFI) Pain score. Secondary outcome measures were function, as scored by the FFI Activity, FFI Disability, and American Orthopaedic Foot & Ankle Society, and quality of life, as scored with the short version of the World Health Organization Quality of Life (WHOQOL-BREF). All outcomes were measured at baseline and at 4, 12, and 26 weeks and 1 year after the procedure.Results: Of the 115 patients, 63 were allocated to the PRP group, of which 46 (73{\%}) completed the study, and 52 were allocated to the control group (corticosteroid injection), of which 36 (69{\%}) completed the study. In the control group, FFI Pain scores decreased quickly and then remained stable during follow-up. In the PRP group, FFI Pain reduction was more modest but reached a lower point after 12 months than the control group. After adjusting for baseline differences, the PRP group showed significantly lower pain scores at the 1-year follow-up than the control group (mean difference, 14.4; 95{\%} CI, 3.2-25.6). The number of patients with at least 25{\%} improvement (FFI Pain score) between baseline and 12-month follow-up differed significantly between the groups. Of the 46 patients in the PRP group, 39 (84.4{\%}) improved at least 25{\%}, while only 20 (55.6{\%}) of the 36 in the control group showed such an improvement (P = .003). The PRP group showed significantly lower FFI Disability scores than the control group (mean difference, 12.0; 95{\%} CI, 2.3-21.6).Conclusion: Treatment of patients with chronic plantar fasciitis with PRP seems to reduce pain and increase function more as compared with the effect of corticosteroid injection.",
keywords = "CORTICOSTEROID INJECTION, DIAGNOSIS, EFFICACY, FOOT FUNCTION INDEX, RUPTURE, THERAPY, VALIDATION, corticosteroids, function, pain, plantar fasciitis, platelet-rich plasma",
author = "Peerbooms, {Joost C} and Paul Lodder and {den Oudsten}, {Brenda L} and Kamiel Doorgeest and Schuller, {Hans M} and Taco Gosens",
year = "2019",
doi = "10.1177/0363546519877181",
language = "English",
volume = "47",
pages = "3238--3246",
journal = "The American Journal of Sports Medicine",
issn = "0363-5465",
publisher = "SAGE Publications Inc.",
number = "13",

}

Positive effect of platelet-rich plasma on pain in plantar fasciitis : A double-blind multicenter randomized controlled trial. / Peerbooms, Joost C; Lodder, Paul; den Oudsten, Brenda L; Doorgeest, Kamiel; Schuller, Hans M; Gosens, Taco.

In: The American Journal of Sports Medicine, Vol. 47, No. 13, 2019, p. 3238-3246.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Positive effect of platelet-rich plasma on pain in plantar fasciitis

T2 - A double-blind multicenter randomized controlled trial

AU - Peerbooms, Joost C

AU - Lodder, Paul

AU - den Oudsten, Brenda L

AU - Doorgeest, Kamiel

AU - Schuller, Hans M

AU - Gosens, Taco

PY - 2019

Y1 - 2019

N2 - Background: When nonoperative treatment for chronic plantar fasciitis fails, often a corticosteroid injection is given. Corticosteroid injection gives temporary pain reduction but no healing. Platelet-rich plasma (PRP) has proven to be a safe therapeutic option in the treatment of tendon, muscle, bone, and cartilage injuries.Purpose: To determine the effectiveness of PRP as compared with corticosteroid injections for chronic plantar fasciitis.STUDY DESIGN: Randomized controlled trial; Level of evidence, 1.Methods: Patients with chronic plantar fasciitis were allocated to have steroid injection or PRP. The primary outcome measure was the Foot Function Index (FFI) Pain score. Secondary outcome measures were function, as scored by the FFI Activity, FFI Disability, and American Orthopaedic Foot & Ankle Society, and quality of life, as scored with the short version of the World Health Organization Quality of Life (WHOQOL-BREF). All outcomes were measured at baseline and at 4, 12, and 26 weeks and 1 year after the procedure.Results: Of the 115 patients, 63 were allocated to the PRP group, of which 46 (73%) completed the study, and 52 were allocated to the control group (corticosteroid injection), of which 36 (69%) completed the study. In the control group, FFI Pain scores decreased quickly and then remained stable during follow-up. In the PRP group, FFI Pain reduction was more modest but reached a lower point after 12 months than the control group. After adjusting for baseline differences, the PRP group showed significantly lower pain scores at the 1-year follow-up than the control group (mean difference, 14.4; 95% CI, 3.2-25.6). The number of patients with at least 25% improvement (FFI Pain score) between baseline and 12-month follow-up differed significantly between the groups. Of the 46 patients in the PRP group, 39 (84.4%) improved at least 25%, while only 20 (55.6%) of the 36 in the control group showed such an improvement (P = .003). The PRP group showed significantly lower FFI Disability scores than the control group (mean difference, 12.0; 95% CI, 2.3-21.6).Conclusion: Treatment of patients with chronic plantar fasciitis with PRP seems to reduce pain and increase function more as compared with the effect of corticosteroid injection.

AB - Background: When nonoperative treatment for chronic plantar fasciitis fails, often a corticosteroid injection is given. Corticosteroid injection gives temporary pain reduction but no healing. Platelet-rich plasma (PRP) has proven to be a safe therapeutic option in the treatment of tendon, muscle, bone, and cartilage injuries.Purpose: To determine the effectiveness of PRP as compared with corticosteroid injections for chronic plantar fasciitis.STUDY DESIGN: Randomized controlled trial; Level of evidence, 1.Methods: Patients with chronic plantar fasciitis were allocated to have steroid injection or PRP. The primary outcome measure was the Foot Function Index (FFI) Pain score. Secondary outcome measures were function, as scored by the FFI Activity, FFI Disability, and American Orthopaedic Foot & Ankle Society, and quality of life, as scored with the short version of the World Health Organization Quality of Life (WHOQOL-BREF). All outcomes were measured at baseline and at 4, 12, and 26 weeks and 1 year after the procedure.Results: Of the 115 patients, 63 were allocated to the PRP group, of which 46 (73%) completed the study, and 52 were allocated to the control group (corticosteroid injection), of which 36 (69%) completed the study. In the control group, FFI Pain scores decreased quickly and then remained stable during follow-up. In the PRP group, FFI Pain reduction was more modest but reached a lower point after 12 months than the control group. After adjusting for baseline differences, the PRP group showed significantly lower pain scores at the 1-year follow-up than the control group (mean difference, 14.4; 95% CI, 3.2-25.6). The number of patients with at least 25% improvement (FFI Pain score) between baseline and 12-month follow-up differed significantly between the groups. Of the 46 patients in the PRP group, 39 (84.4%) improved at least 25%, while only 20 (55.6%) of the 36 in the control group showed such an improvement (P = .003). The PRP group showed significantly lower FFI Disability scores than the control group (mean difference, 12.0; 95% CI, 2.3-21.6).Conclusion: Treatment of patients with chronic plantar fasciitis with PRP seems to reduce pain and increase function more as compared with the effect of corticosteroid injection.

KW - CORTICOSTEROID INJECTION

KW - DIAGNOSIS

KW - EFFICACY

KW - FOOT FUNCTION INDEX

KW - RUPTURE

KW - THERAPY

KW - VALIDATION

KW - corticosteroids

KW - function

KW - pain

KW - plantar fasciitis

KW - platelet-rich plasma

U2 - 10.1177/0363546519877181

DO - 10.1177/0363546519877181

M3 - Article

C2 - 31603721

VL - 47

SP - 3238

EP - 3246

JO - The American Journal of Sports Medicine

JF - The American Journal of Sports Medicine

SN - 0363-5465

IS - 13

ER -