Short-term study shows better results with PRP vs. cortisone for plantar fasciitis

COPENHAGEN — According to a presentation here, an injection of platelet-rich plasma resulted in better foot and ankle scores than cortisone in patients with severe chronic plantar fasciitis.

“I decided to apply the use of platelets and platelet-rich plasma (PRP) technology in this type of refractory case,” Raymond R. Monto, MD, said at the 12th EFORT Congress 2011. “How does it work? We are probably seeing modulation at least of angiogenesis of collagen turnover and some tissue healing.”

In his level 2 study, Monto block randomized 40 patients with chronic plantar fasciitis to receive either a 40 mg cortisone injection or a PRP injection at the site of injury. The injections were guided by ultrasound.

The mean American Orthopaedic Foot & Ankle Society (AOFAS) scores of in the cortisone group increased from 52 points pre-injection to 81 points at 3-months post-treatment. However, Monto found that the score dropped to 74 points after 6 months. The pre-injection AOFAS score of the PRP group increased from 37 points to 95 points at 3 months.

“I think the interesting finding here is that they maintained those high levels of results,” Monto said, adding that no patients were lost to follow-up or experienced complications.

“In this well-documented subset, PRP is significantly more effective than cortisone both in short- and long-term management for severe chronic plantar fasciitis,” he said.

Reference:
Monto RR. Platelet rich plasma is more effective than cortisone injection for chronic plantar fasciitis. Paper #652. Presented at the 12th EFORT Congress 2011. June 1-4. Copenhagen.