Atzmon Ran, Eilig Dynai, Dubin Jeremy, Vidra Matias, Marom Omer, Tavdi Alex, Drexler Michael, Palmanovich Esequiel
Assuta Medical Center, Department of Orthopaedic Surgery, Affiliated with the Faculty of Health and Science and Ben Gurion University, Ha-Refu'a St. 7, Ashdod 7747629, Israel.
Tel Aviv Medical Center, Department of Orthopaedic Surgery, Affiliated with the Sackler Faculty of Medicine and Tel Aviv University, Weizmann St. 6, Tel Aviv 6423906, Israel.
J Clin Med. 2022 Nov 26;11(23):6986. doi: 10.3390/jcm11236986.
Platelet-Rich Plasma (PRP) injection has become a desirable alternative to Partial Plantar Fasciotomy (PPF) surgery and steroid injection for patients with chronic plantar fasciitis (CPF) due to its potential for shorter recovery times, reduced complications, and similar activity scores. As such, we compared PRP treatment to PPF surgery in patients with CPF. Between January 2015 and January 2017, patients were randomly divided into two groups, a PRP treatment group, and a PPF group. All procedures were performed by a single foot and ankle fellowship-trained specialist surgeon. Visual Analog Score (VAS) and Roles-Maudsley Scale (RM) were collected during the preoperative visit and 3, 6, and 12 months postoperatively. The patients were also closely followed by a physiotherapist. There were 16 patients in each group after four patients refused to participate. Patients in the PPF had low Roles-Maudsley Scale (RM) scores compared to the PRP group one-year after treatment (3.77 vs. 2.72, < 0.0001). Both procedures showed a reduction in RM scores during the follow-up year (9 to 1.62 for PPF and 8.7 to 2.4 for PRP). There was no significant change in VAS pain between the two groups ( = 0.366). Patients treated with PRP injection reported a significant increase in their activity scores, shorter recovery time, and lower complication rates compared to PPF treatment. Moreover, with respect to existing literature, PRP may be as efficient as steroid injection with lower complication rates, including response to physical therapy. Therefore, PRP treatment may be a viable option before surgery as an earlier line treatment for CPF. Level of Clinical Evidence: II.
富血小板血浆(PRP)注射已成为慢性足底筋膜炎(CPF)患者的一种理想选择,可替代部分足底筋膜切开术(PPF)和类固醇注射,因为它有可能缩短恢复时间、减少并发症并获得相似的活动评分。因此,我们比较了CPF患者中PRP治疗与PPF手术的效果。在2015年1月至2017年1月期间,患者被随机分为两组,即PRP治疗组和PPF组。所有手术均由一位接受过足踝专科培训的专科医生进行。在术前访视以及术后3个月、6个月和12个月时收集视觉模拟评分(VAS)和罗尔斯-莫兹利量表(RM)。患者还由一名物理治疗师密切随访。在4名患者拒绝参与后,每组各有16名患者。治疗一年后,PPF组患者的罗尔斯-莫兹利量表(RM)得分低于PRP组(3.77对2.72,<0.0001)。在随访年度内,两种手术的RM得分均有所降低(PPF组从9降至1.62,PRP组从8.7降至2.4)。两组之间的VAS疼痛评分无显著变化(=0.366)。与PPF治疗相比,接受PRP注射治疗的患者报告其活动评分显著提高、恢复时间更短且并发症发生率更低。此外,就现有文献而言,PRP可能与类固醇注射一样有效,且并发症发生率更低,包括对物理治疗的反应。因此,PRP治疗可能是CPF手术前作为早期一线治疗的可行选择。临床证据水平:II级。