Advertisement

Comparison of Regenerative Injection Therapy and Conventional Therapy, for Proximal Plantar Fasciitis

Published:November 22, 2022DOI:https://doi.org/10.1053/j.jfas.2022.11.010

      Abstract

      Treatment of subacute and chronic heel pain often presents a unique challenge to the physician. Regenerative therapies, such as injectable amnion and connective tissue matrix, may represent a promising new approach in these patients, and have become increasingly popular in the US. However, while promising in nature, little literature exists evaluating these injections compared to conventional nonoperative means. As such, we designed a retrospective comparative study evaluating patients in our practice who received a standardized plantar fascial treatment protocol only (standard therapy), and those who received regenerative plantar fascial injections in addition to standard therapy. A total of 54 patients were followed over a 3-month observation period (91.7 ± 73.9 days), with numeric pain rating (NPR) serving as the primary outcome. Both groups saw an improvement in NPR at the end of the observation period, but patients in the regenerative therapy group demonstrated lower pain scores than those receiving standard therapy alone (mean NPR 2.1 ± 2.3 versus 4.4 ± 2.8, p=0.004). Additionally, those in the standard therapy group were significantly more likely to proceed onto surgical intervention compared to the regenerative therapy group (unadjusted odds ratio 15.6, 95% CI 3.0-27.9). The use of regenerative injections for subacute and chronic plantar fasciitis showed promise in our study, and may help mitigate against the need for invasive surgical intervention., Level of Clinical Evidence: III, Retrospective Comparative Study

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Foot and Ankle Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • DiGiovanni B
        • Moore A
        • Zlotnicki J
        • Pinney S.
        Preferred management of recalcitrant plantar fasciitis among orthopaedic foot and ankle surgeons.
        Foot Ankle Int. 2012; 33: 507-512
        • Riddle DL
        • Scappert SM.
        Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors.
        Foot Ankle Int. 2004; 25: 303-310
        • Kamonseki DH
        • Gonçalves GA
        • Yi LC
        • et al.
        Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: a randomized controlled single-blind clinical trial.
        Man Ther. 2016; 23: 76-82
        • James AM
        • Williams CM
        • Haines TP.
        Effectiveness of footwear and foot orthoses for calcaneal apophysitis: a 12-month factorial randomised trial.
        Br J Sports Med. 2016; 250: 1268-1275
        • Lee WC
        • Wong WY
        • Kung E
        • et al.
        Effectiveness of adjustable dorsiflexion night splint in combination with accommodative foot orthosis on plantar fasciitis.
        J Rehabil Res Dev. 2012; 49: 1557-1564
        • Aqil A
        • Siddiqui MR
        • Solan M
        • et al.
        Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs.
        Clin Orthop Relat Res. 2013; 471: 3645-3652
        • Mahindra P
        • Yamin M
        • Selhi HS
        • et al.
        Chronic plantar fasciitis: effect of platelet-rich plasma, corticosteroid, and placebo.
        Orthopedics. 2016; 39: e285-e289
        • Benton-Weil W
        • Borrelli AH
        • Weil Jr, LS
        • Weil Sr., LS
        Percutaneous plantar fasciotomy: a minimally invasive procedure for recalcitrant plantar fasciitis.
        J Foot Ankle Surg. 1998; 37: 269-272
        • Cazzell S
        • Steward J
        • Agnew PS
        • Senatore J
        • Walters J
        • Murdoch D
        • Reyzelman A
        • Miller SD.
        Randomized controlled trial of micronized dehydrated human amnion/chorion membrane injection compared to placebo for the treatment of plantar fasciitis.
        Foot Ankle Int. 2018; 39: 1151-1161
        • Ma R
        • Schär M
        • Chen T
        • Wang H
        • Wada S
        • Ju X
        • Deng XH
        • Rodeo SA.
        Use of Human Placenta-Derived Cells in a Preclinical Model of Tendon Injury.
        J Bone Joint Surg Am. 2019; 101: e61
        • de Girolamo L
        • Morlin Ambra LF
        • Perucca Orfei C
        • McQuilling JP
        • Kimmerling KA
        • Mowry KC
        • Johnson KA
        • Phan AT
        • Whited JL
        • Gomoll AH
        Treatment with Human Amniotic Suspension Allograft Improves Tendon Healing in a Rat Model of Collagenase-Induced Tendinopathy.
        Cells. 2019; 8: 1411
        • Gomoll AH
        • Farr J
        • Cole BJ
        • Flanigan DC
        • Lattermann C
        • et al.
        Safety and Efficacy of an Amniotic Suspension Allograft Injection Over 12 Months in a Single-Blinded, Randomized Controlled Trial for Symptomatic Osteoarthritis of the Knee.
        Arthroscopy. 2021; 37: 2246-2257
        • Monteagudo M
        • de Albornoz PM
        • Gutierrez B
        • Tabuenca J
        • Álvarez I.
        Plantar fasciopathy: A current concepts review.
        EFORT Open Rev. 2018; 3: 485-493