Analgesic efficacy and functional outcome in refractory cases of plantar fasciitis treated with platelet-rich plasma: randomized comparative study with corticosteroids injection

Figures & data

Figure 1. US-guided pre- & post-PRP injection follow up of fascia thickness..

Figure 2. US-guided pre- & post-steroid injection follow up of fascia thickness..

Figure 3. Flow chart of the study.

Table 1. Demographic data with pre and post-treatment evaluation of the two studied groups.

		Drug used		Test of significance
		PRP	Steroids
		(N= 30)	(N= 30)
		Mean ± SD	Mean ± SD	p-Value	Sig.
	Age (years)	46.67 ± 6.33	44.4 ± 7.36	0.206(T)	NS
	BMI (kg/m^2)	31.03 ± 2.36	31.77 ± 2.27	0.224(T)	NS
		n (%)	n (%)
Sex	Male	9 (30%)	4 (13.33%)	0.117(C)	NS
	Female	21 (70%)	26 (86.67%)
ASA	I	25 (83.33%)	26 (86.67%)	1.00(F)	NS
	II	5 (16.67%)	4 (13.33%)
		Mean ± SD	Mean ± SD
Duration of heel pain (months)		10.9 ± 4.42	10.9 ± 4.42	1.00(T)	NS
Duration of pain post-injection (hours)		74.4 ± 7.32	0 ± 0	<0.001**(T)	HS

Data were expressed as mean±standard deviation (SD), number (n) & percentage (%), Platelet-rich plasma(PRP), body mass index(BMI) , American society of anethesiologists(ASA), (T) t-test of significance, (C) Chi-Square test of significance, (F) Fisher’s Exact test of significance, non-significant(NS), ** highly significant(HS).

Table 2. VAS between the two studied groups.

			Drug used		Student t-test
			PRP	Steroids	p-Value	Sig.
			(N= 30)	(N= 30)
VAS	Pre-injection	Mean ± SD	7.87 ± 0.63	7.83 ± 0.7	0.847	NS
		Median (IQR)	8 [7,8]	8 [7,8]
	3w post-injection	Mean ± SD	6.13 ± 0.9	4.1 ± 1.37	<0.001**	HS
		Median (IQR)	6 [5–7]	4 [3–5]
		% of change	−22.80%	−47.60%
	6w post-injection	Mean ± SD	4.4 ± 1.33	4.8 ± 1.61	0.298	NS
		Median (IQR)	4 [4,5]	4 [3–7]
		% of change	−44.30%	−38.70%
	12w post-injection	Mean ± SD	3.23 ± 2.19	5.63 ± 1.25	<0.001**	HS
		Median (IQR)	2 [2,3]	5.5 [5] - [7]
		% of change	−59.50%	−28.50%
	6m post-Injection	Mean ± SD	3.5 ± 2.16	5.97 ± 1.1	<0.001**	HS
		Median (IQR)	3 [2,3]	6 [6,7]
		% of change	−55.70%	−23.40%

Data were expressed as mean±standard deviation (SD), median, interquartile range(IQR), number (n) & percentage (%), Platelet-rich plasma(PRP), visual analog score(VAS), (T) t-test of significance, (C) Chi-Square test of significance, (F) Fisher’s Exact test of significance, non-significant(NS), p˂0.001** highly significant(HS)..

Table 3. AOFAS between the two studied groups.

			Drug used		Student t-test
			PRP(N= 30)	Steroids(N= 30)	p-Value	Sig.
AOFAS score	Pre-injection	Mean ± SD	47.47 ± 5.62	47.87 ± 5.96	0.79	NS
		Median (IQR)	49 (44 - 52)	49 (44 - 52)
	3w post-Injection	Mean ± SD	63.37 ± 7.62	77.97 ± 11.88
		Median (IQR)	65 (60 - 66)	84 (65 - 87)	<0.001**	HS
		% of change	33.5%	62.8%
	6w post-injection	Mean ± SD	77.8 ± 10.63	74.67 ± 13.31
		Median (IQR)	80 (75 - 85)	79 (60 - 85)	0.318	NS
		% of change	63.8%	55.9%
	12w post-injection	Mean ± SD	85.3 ± 15.15	68.2 ± 11.42
		Median (IQR)	92 (88 - 94)	68 (56 - 78)	<0.001**	HS
		% of change	79.6%	42.4%
	6m post-injection	Mean ± SD	83.67 ± 15.91	63.6 ± 9.72
		Median (IQR)	90.5 (87 - 92)	61 (56 - 68)	<0.001**	HS
		% of change	76.20%	32.80%

Data were expressed as mean±standard deviation (SD), median, interquartile range(IQR), number (n) & percentage (%), Platelet-rich plasma(PRP), (T) t-test of significance, (C) Chi-Square test of significance, (F) Fisher’s Exact test of significance, non-significant(NS), p˂0.001** highly significant(HS).

Table 4. Diameter of fascia between the two studied groups.

			Drug used		Student t-test
			PRP (N= 30)	Steroids (N= 30)	p-Value	Sig.
Diameter of fascia (mm)	Pre-injection	Mean ± SD	6.94 ± 0.81	6.89 ± 0.82	0.8	NS
	3w post-injection	Mean ± SD	6.48 ± 0.74	5.64 ± 0.63	<0.001**	HS
		% of change	−5.8%	−18.8%
	6w post-injection	Mean ± SD	5.86 ± 0.68	5.74 ± 0.66	0.491	NS
		% of change	−14.5%	−17.4%
	12w post-injection	Mean ± SD	5 ± 0.69	6.01 ± 0.55	<0.001**	HS
		% of change	−27.5%	−13.0%
	6m post-injection	Mean ± SD	4.87 ± 0.71	6 ± 0.56	<0.001**	HS
		% of change	−29.0%	−13.0%

Data were expressed as mean ± standard deviation (SD), median, interquartile range(IQR), number (n) & percentage (%), Platelet-rich plasma(PRP), weeks(w), months(m), (T) t-test of significance, (C) Chi-Square test of significance, (F) Fisher’s Exact test of significance, non-significant(NS), p˂0.001** highly significant(HS). percentage(%), American orthopedic foot and ankle society(AOFAS), linear regression(R).

Figure 4. Correlation between percentage of change in AOFAS & diameter of fascia at 6 weeks.

Percentage (%), American orthopedic foot and ankle society(AOFAS), linear regression(R)

Figure 5. Correlation between percentage of change in AOFAS & diameter of fascia at 6 months.

Figure 6. Need for analgesia along course of follow up.

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