Department of Physical Education, Korea National Sport University, Seoul, Republic of Korea∗
Department of Physical Medicine and Rehabilitation, School of Medicine, Kyung Hee University, 130-701, 1 Hoegi-dong, Dongdaemun-gu, Seoul, Republic of Korea(†).
PM R. 2014 Feb;6(2):152-8. doi: 10.1016/j.pmrj.2013.07.003. Epub 2013 Jul 19.
To determine the efficacy of autologous platelet-rich plasma (PRP) compared with dextrose prolotherapy (DP) in patients with chronic recalcitrant plantar fasciitis (PF) DESIGN: A single-blinded, randomized, controlled study.
Department of Physical Medicine and Rehabilitation of a university hospital.
Twenty-one patients with a clinical diagnosis of chronic PF confirmed by diagnostic ultrasound (plantar fascia thickness >4 mm) were randomly assigned to the PRP group (n = 10) or the DP group (n = 11).
Each patient received 2 injections into the plantar fascia through a peppering technique under ultrasound guidance at an interval of 2 weeks, either with 2 mL of autologous PRP or 2 mL of 15% dextrose/lidocaine solution.
The outcome measures included the pain, disability, and activity limitation subscales, measured by means of the Foot Functional Index. Data were collected before the first injection, at 2 weeks (before the second injection), and at the 2- and 6-month follow-ups.
All patients completed the follow-ups, with the exception of 1 patient in the PRP group. The mean Foot Functional Index total and subcategory score improvements were greater in the PRP group compared with the DP group (improvement with PRP vs DP, total: 30.4% vs 15.1%, pain: 29.7% vs 17.1%, disability: 26.6% vs 14.5%, activity limitation: 28.0% vs 12.4%). However, no statistically significant difference was noted at any follow-up. In the pain and disability subcategories, both groups showed significant improvements at the last re-evaluation. The PRP group also showed significant improvements in the disability and activity limitation subscales at the second re-evaluation.
Each treatment seems to be effective for chronic recalcitrant PF, expanding the treatment options for patients in whom conservative care has failed. PRP treatment also may lead to a better initial improvement in function compared with DP treatment.
比较富血小板血浆（PRP）与葡萄糖普鲁卡因(prolotherapy，DP)治疗慢性顽固性足底筋膜炎（PF）的疗效。
单盲、随机、对照研究。
某大学医院康复医学科。
21 例经超声（足底筋膜厚度>4mm）确诊为慢性 PF 的患者被随机分配到 PRP 组（n=10）或 DP 组（n=11）。
每位患者均在超声引导下通过胡椒喷雾技术于 2 周间隔向足底筋膜内注射 2ml 自体 PRP 或 15%葡萄糖/利多卡因溶液。
采用足部功能指数（Foot Functional Index）测量疼痛、残疾和活动受限亚量表评估结局。数据在首次注射前、第 2 周（第二次注射前）以及第 2 和 6 个月随访时收集。
除 PRP 组 1 例患者失访外，所有患者均完成随访。与 DP 组相比，PRP 组的足部功能指数总分和各亚量表评分改善更明显（PRP 组与 DP 组相比，改善幅度：总分 30.4%比 15.1%，疼痛 29.7%比 17.1%，残疾 26.6%比 14.5%，活动受限 28.0%比 12.4%）。然而，在任何随访时均未发现统计学差异。在疼痛和残疾亚量表中，两组在最后一次评估时均显示出显著改善。PRP 组在第二次评估时在残疾和活动受限亚量表中也显示出显著改善。
两种治疗方法对慢性顽固性 PF 均有效，为保守治疗失败的患者提供了更多的治疗选择。与 DP 治疗相比，PRP 治疗可能会导致初始功能改善更好。
