Nepal Orthopaedic Hospital, Kathmandu, Nepal.
Department of Nutrition and Dietetics, Nepal Armed Police Force Hospital, Kathmandu, Nepal.
BMC Musculoskelet Disord. 2023 Mar 7;24(1):172. doi: 10.1186/s12891-023-06277-1.
Plantar fasciitis (PF) is a common orthopaedic problem, with heel pain worsening the quality of life. Although steroid injection is often used if the conservative treatment fails, Platelet-Rich Plasma (PRP) injection is gaining popularity due to its safety and long-lasting effect. However, the effect of PRP versus steroid injection in PF has not been studied yet in Nepal. Therefore, this study aimed to assess the effect of PRP compared with steroid injection in the treatment of PF.
This study was a single-center, hospital-based, open-label, parallel-group randomized clinical trial to compare the effect of PRP injection with steroid injection in plantar fasciitis between August 2020 and March 2022. A total of 90 randomly selected participants aged 18 to 60 years suffering from plantar fasciitis with failed conservative treatment were intervened. The American Orthopaedic Foot and Ankle Society (AOFAS) and the Visual Analog Scale (VAS) scoring system were used to evaluate functional mobility and pain before and after the intervention for three and six months, respectively. Statistical analyses were performed using a Student's two-sample t-test. P-value < 0.05 was considered statistically significant.
The PRP injection showed a better outcome than the steroid injection in six months follow-up. The mean (± SD) VAS score was significantly decreased in the PRP group (1.97 + 1.13) than in the steroid group (2.71 ± 0.94) with the group difference of -0.73 (95% CI: -1.18 to -0.28) at six months. Similarly, there was a significant increase in the AOFAS scores in the PRP group (86.04 ± 7.45) compared to the steroid group (81.23 ± 9.60) at six months of follow-up with a group difference of 4.80 (95% CI: 1.15 to 8.45). There was also a significant reduction of plantar fascia thickness in the PRP group compared to that of the steroid group (3.53 ± 0.81 versus 4.58 ± 1.02) at six months of follow-up with the group difference of -1.04 (95% CI: -1.44 to -0.65).
The PRP injection showed better outcomes than steroid injection in plantar fasciitis treatment over the course of six months. Further research with a larger population and longer follow-up than six months is needed to generalize the findings and their long-term efficacy.
NCT04985396. First registered on 02 August 2021. ( https://clinicaltrials.gov/ct2/show/NCT04985396 ).
足底筋膜炎（PF）是一种常见的骨科问题，足跟疼痛会降低生活质量。如果保守治疗失败，常采用皮质类固醇注射，但由于其安全性和长效性，富血小板血浆（PRP）注射越来越受欢迎。然而，在尼泊尔，PRP 与皮质类固醇注射治疗 PF 的效果尚未得到研究。因此，本研究旨在评估 PRP 与皮质类固醇注射治疗 PF 的效果。
这是一项 2020 年 8 月至 2022 年 3 月在尼泊尔一家医院进行的单中心、基于医院的、开放标签、平行组随机临床试验，旨在比较 PRP 注射与皮质类固醇注射治疗足底筋膜炎的效果。共纳入 90 名随机选择的年龄在 18 至 60 岁之间、经保守治疗失败的足底筋膜炎患者。采用美国矫形足踝协会（AOFAS）和视觉模拟评分（VAS）评分系统分别在干预后 3 个月和 6 个月评估功能活动度和疼痛。使用学生 t 检验进行统计分析。P 值 < 0.05 被认为具有统计学意义。
PRP 注射在 6 个月随访时的效果优于皮质类固醇注射。PRP 组的 VAS 评分（1.97 ± 1.13）显著低于皮质类固醇组（2.71 ± 0.94），组间差异为 -0.73（95%CI：-1.18 至 -0.28）。同样，PRP 组 AOFAS 评分（86.04 ± 7.45）在 6 个月随访时也显著高于皮质类固醇组（81.23 ± 9.60），组间差异为 4.80（95%CI：1.15 至 8.45）。PRP 组的足底筋膜厚度也显著低于皮质类固醇组（3.53 ± 0.81 与 4.58 ± 1.02），组间差异为 -1.04（95%CI：-1.44 至 -0.65）。
PRP 注射在足底筋膜炎治疗中优于皮质类固醇注射，效果持续 6 个月。需要进行更大规模的人群研究和更长时间（超过 6 个月）的随访，以推广研究结果及其长期疗效。
NCT04985396。首次注册于 2021 年 8 月 2 日。（https://clinicaltrials.gov/ct2/show/NCT04985396）。
