Tabrizi Ali, Dindarian Sina, Mohammadi Sedra
Assistant Professor, Department of Orthopedics, Clinical Research Development Unit of Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.
Medical Student and Researcher, Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran.
J Foot Ankle Surg. 2020 Jan-Feb;59(1):64-68. doi: 10.1053/j.jfas.2019.07.004.
Chronic plantar heel pain (CPHP) is one of the most common painful and disabling foot conditions, for which various treatments have been proposed. We aimed to investigate the efficacy of local injection of platelet-rich plasma (PRP) compared with the conventional method of local corticosteroid injection in obese patients who were resistant to other nonsurgical treatments. In this single-blind, randomized clinical trial, 32 obese patients with chronic plantar heel pain were randomly allocated to 2 groups of 16 participants each. In 1 group, 40 mg of dimethylprednisolone was injected once into the painful heel, whereas the other group received 3 separate injections of PRP, with each injection administered 1 week apart. The groups were compared at baseline and at 24 weeks after the injection, or course of injections, was administered. Exposures, total morning pain, and foot function index were not statistically significantly different between the groups at baseline; however, at 24 weeks after the treatment, final pain and morning pain scores were statistically significantly (p < .001) better in the corticosteroid group, and the mean foot function index scores were 65.4 ± 3.2 and 58.3 ± 2.9 (p < .001) in patients treated with corticosteroid and PRP, respectively. In obese patients with plantar fasciitis, injection with corticosteroid was more effective than PRP at reducing pain and improving function.
慢性足跟痛是最常见的引起疼痛和导致足部功能障碍的病症之一,针对此病症已提出了各种治疗方法。我们旨在研究在对其他非手术治疗有抵抗性的肥胖患者中,局部注射富血小板血浆(PRP)与传统局部注射皮质类固醇方法相比的疗效。在这项单盲随机临床试验中,32例患有慢性足跟痛的肥胖患者被随机分为两组,每组16名参与者。一组将40mg二甲基泼尼松龙一次性注射到疼痛的足跟,而另一组接受3次单独的PRP注射,每次注射间隔1周。在基线时以及注射后24周或整个注射疗程结束后对两组进行比较。两组在基线时的暴露情况、总的晨起疼痛和足部功能指数没有统计学显著差异;然而,在治疗后24周,皮质类固醇组的最终疼痛和晨起疼痛评分在统计学上显著更好(p < 0.001),接受皮质类固醇和PRP治疗的患者的平均足部功能指数评分分别为65.4±3.2和58.3±2.9(p < 0.001)。在患有足底筋膜炎的肥胖患者中,注射皮质类固醇在减轻疼痛和改善功能方面比PRP更有效。