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Ultrasound-Guided Autologous Platelet-Rich Plasma Injections Versus Focal Ultrasound-Guided Extracorporeal Shockwave Therapy for Plantar Fasciitis in Athletes and Nonathletes: A Retrospective Comparative Study With Minimum 2-Year Follow-Up

Published:October 26, 2022DOI:https://doi.org/10.1053/j.jfas.2022.10.005

      Abstract

      Plantar fasciitis is often cause of heel pain, especially in sporting-related activities. Different conservative measures for the management of plantar fasciitis were compared in several researches. The purpose of this retrospective study was to evaluate and compare clinical outcomes of chronic plantar fasciitis treated with ultrasound-guided platelet-rich plasma (PRP) and focal ultrasound-guided extracorporeal shockwave therapy (ESW). Secondarily, results on subpopulation of athletes were recorded. Fifty-five patients treated for plantar fasciitis were included, 24 among them were competitive or recreational athletes. Treatment outcomes were assessed using Visual Analog Scale and Foot Function Index before and after treatment. Time to return to sport among patients practicing sporting activities was recorded. Before treatment, no differences were observed between groups in terms of age, gender, body mass index, and months of follow up. From baseline to final follow-up assessment, significant improvement was observed in all the outcomes measures. The subgroup analysis showed no differences between patients stratified for type of treatment and sport/nonsport practitioners. The overall failure rate was higher, although not significant, in patients who underwent ESW therapy and they required a higher number of orthopedic visits. Among sports practitioners the mean time to return to sport (months) was faster in PRP group than ESW group (p = .044). PRP and ESW represent both reliable solutions for plantar fasciitis leading to good results in terms of patients’ satisfaction, pain, and clinical outcomes. However, after treatment with PRP injections less recurrences in overall population and faster return to sporting activities in sports practitioners were observed.

      Level of Clinical Evidence

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      References

        • Lemont H
        • Ammirati KM
        • Usen N.
        Plantar fasciitis: a degenerative process (fasciosis) without inflammation.
        J Am Podiatr Med Assoc. 2003; 93: 234-237
        • Lareau CR
        • Sawyer GA
        • Wang JH
        • DiGiovanni CW.
        Plantar and medial heel pain: diagnosis and management.
        J Am Acad Orthop Surg. 2014; 22: 372-380
        • Landorf KB
        • Menz HB.
        Plantar heel pain and fasciitis.
        BMJ Clin Evid. 2008; 2008: 1111
        • Taunton JE
        • Ryan MB
        • Clement DB
        • McKenzie DC
        • Lloyd-Smith DR
        • Zumbo BD.
        A retrospective case-control analysis of 2002 running injuries.
        Br J Sports Med. 2002; 36: 95-101
        • Thomas JL
        • Christensen JC
        • Kravitz SR
        • Mendicino RW
        • Schuberth JM
        • Vanore JV
        • Weil LS Sr
        • Zlotoff HJ
        • Bouché R
        • Baker J
        The diagnosis and treatment of heel pain: a clinical practice guideline-revision 2010.
        J Foot Ankle Surg. 2010; 49: S1-19
        • Buchbinder R.
        Clinical practice. Plantar fasciitis.
        N Engl J Med. 2004; 350: 2159-2166
        • Zhou B
        • Zhou Y
        • Tao X
        • Yuan C
        • Tang K.
        Classification of calcaneal spurs and their relationship with plantar fasciitis.
        J Foot Ankle Surg. 2015; 54: 594-600
        • Rossi F
        • Zaottini F
        • Picasso R
        • Martinoli C
        • Tagliafico AS.
        Ankle and foot ultrasound: reliability of side-to-side comparison of small anatomic structures.
        J Ultrasound Med. 2019; 38: 2143-2153
        • Fazal MA
        • Tsekes D
        • Baloch I.
        Is there a role for MRI in plantar heel pain.
        Foot Ankle Spec. 2018; 11: 242-245
        • Neufeld SK
        • Cerrato R.
        Plantar fasciitis: evaluation and treatment.
        J Am Acad Orthop Surg. 2008; 16: 338-346
        • Huffer D
        • Hing W
        • Newton R
        • Clair M
        Strength training for plantar fasciitis and the intrinsic foot musculature: a systematic review.
        Phys Ther Sport. 2017; 24: 44-52
        • Schneider HP
        • Baca JM
        • Carpenter BB
        • Dayton PD
        • Fleischer AE
        • Sachs BD.
        American College of Foot and Ankle Surgeons Clinical Consensus Statement: diagnosis and treatment of adult acquired infracalcaneal heel pain.
        J Foot Ankle Surg. 2018; 57: 370-381
        • von Elm E
        • Altman DG
        • Egger M
        • Pocock SJ
        • Gøtzsche PC
        • Vandenbroucke JP
        • et al.
        STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.
        BMJ. 2007; 335: 806-808
        • Carlsson AM.
        Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale.
        Pain. 1983; 16: 87-101
        • Budiman-Mak E
        • Conrad KJ
        • Roach KE.
        The Foot Function Index: a measure of foot pain and disability.
        J Clin Epidemiol. 1991; 44: 561-570
        • Alessio-Mazzola M
        • Repetto I
        • Biti B
        • Trentini R
        • Formica M
        • Felli L.
        Autologous US-guided PRP injection versus US-guided focal extracorporeal shock wave therapy for chronic lateral epicondylitis: a minimum of 2-year follow-up retrospective comparative study.
        J Orthop Surg (Hong Kong). 2018; 262309499017749986
        • Aqil A
        • Siddiqui MR
        • Solan M
        • Redfern DJ
        • Gulati V
        • Cobb JP.
        Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs.
        Clin Orthop Relat Res. 2013; 471: 3645-3652
        • McKinney J
        • Velghe J
        • Fee J
        • Isserow S
        • Drezner JA.
        Defining athletes and exercisers.
        Am J Cardiol. 2019; 123: 532-535
        • Wearing SC
        • Smeathers JE
        • Urry SR
        • Hennig EM
        • Hills AP.
        The pathomechanics of plantar fasciitis.
        Sports Med. 2006; 36: 585-611
        • Saggini R
        • Migliorini M
        • Carmignano SM
        • Ancona E
        • Russo C
        • Bellomo RG.
        Inferior heel pain in soccer players: a retrospective study with a proposal for guidelines of treatment.
        BMJ Open Sport Exerc Med. 2018; 4e000085
        • Caminear D
        • Saxena A
        • Fullem B
        • Gerdesmeyer L.
        • Schneider H
        • Baca J
        • Carpenter B
        • Dayton P
        • Fleischer A
        • Sachs B.
        American College of Foot and Ankle Surgeons Clinical Consensus Statement: diagnosis and treatment of adult acquired infracalcaneal heel pain.
        J Foot Ankle Surg. 2018; 57: 1051-1052
        • Saxena A
        • Hong BK
        • Yun AS
        • Maffulli N
        • Gerdesmeyer L.
        Treatment of plantar fasciitis with radial soundwave "Early" is better than after 6 months: a pilot study.
        J Foot Ankle Surg. 2017; 56: 950-953
        • Martin RL
        • Davenport TE
        • Reischl SF
        • McPoil TG
        • Matheson JW
        • Wukich DK
        • et al.
        American physical therapy association. heel pain-plantar fasciitis: revision 2014.
        J Orthop Sports Phys Ther. 2014; 44: A1-33
        • Goff JD
        • Crawford R.
        Diagnosis and treatment of plantar fasciitis.
        Am Fam Physician. 2011; 84: 676-682
        • Morrissey D
        • Cotchett M
        • Said J'Bari A
        • Prior T
        • Griffiths IB
        • Rathleff MS
        • et al.
        Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values.
        Br J Sports Med. 2021; 55: 1106-1118
        • Jain SK
        • Suprashant K
        • Kumar S
        • Yadav A
        • Kearns SR.
        Comparison of plantar fasciitis injected with platelet-rich plasma vs corticosteroids.
        Foot Ankle Int. 2018; 39: 780-786
        • Peerbooms JC
        • Lodder P
        • den Oudsten BL
        • Doorgeest K
        • Schuller HM
        • Gosens T.
        Positive effect of platelet-rich plasma on pain in plantar fasciitis: a double-blind multicenter randomized controlled trial.
        Am J Sports Med. 2019; 47: 3238-3246
        • Fei X
        • Lang L
        • Lingjiao H
        • Wei C
        • Zhou X.
        Platelet-rich plasma has better mid-term clinical results than traditional steroid injection for plantar fasciitis: a systematic review and meta-analysis.
        Orthop Traumatol Surg Res. 2021; 107103007
        • Rompe JD
        • Furia J
        • Weil L
        • Maffulli N.
        Shock wave therapy for chronic plantar fasciopathy.
        Br Med Bull. 2007; 81-82: 183-208
        • Dastgir N.
        Extracorporeal shock wave therapy for treatment of plantar fasciitis.
        J Pak Med Assoc. 2014; 64: 675-678
        • Zhiyun L
        • Tao J
        • Zengwu S.
        Meta-analysis of high-energy extracorporeal shock wave therapy in recalcitrant plantar fasciitis.
        Swiss Med Wkly. 2013; 143: w13825
        • Haddad S
        • Yavari P
        • Mozafari S
        • Farzinnia S
        • Mohammadsharifi G.
        Platelet-rich plasma or extracorporeal shockwave therapy for plantar fasciitis.
        Int J Burns Trauma. 2021; 11: 1-8
        • Alessio-Mazzola M
        • Felli L
        • Trentini R
        • Formica M
        • Capello AG
        • Lovisolo S
        • et al.
        Efficacy of autologous platelet-rich plasma Injections for grade 3 symptomatic degenerative meniscal lesions: a 1-year follow-up prospective study.
        Sports Health. 2021; 14: 227-236
        • Obana KK
        • Schallmo MS
        • Hong IS
        • Ahmad CS
        • Moorman CT 3rd
        • Trofa DP
        • et al.
        Current trends in orthobiologics: an 11-year review of the orthopaedic literature.
        Am J Sports Med. 2022; 50: 3121-3129