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Plantar fasiit tedavisinde trombositten zengin plazma ve steroid enjeksiyonunun karşılaştırması

Year 2014, Volume: 48 Issue: 6, 667 - 672, 16.01.2015
https://doi.org/10.3944/AOTT.2014.13.0142

Abstract

Amaç: Bu çalışmada plantar fasiit tanısı konulan hastalarda trombositten zengin plazma (TZP) ve steroid enjeksiyonunun etkilerinin karşılaştırılması amaçlanmaktadır.

Çalışma planı: Kronik plantar fasiit tanısı konan 50 hasta 2 gruba ayrıldı. TZP grubundaki hastaların (n=25) kanlarından hazırlanan TZP kalsiyum klorür ile aktive edilerek, tek doz enjeksiyon uygulandı. Steroid grubundaki hastalara (n=25), tek doz metilprednizolon lokal anestezik ile beraber uygulandı. Klinik değerlendirmede Amerikan Ayak ve Ayak Bileği Skoru (AAAS) ve görsel ağrı skalası (GAS) kullanıldı.

Bulgular: Hastaların hiçbirinde komplikasyon görülmedi. TZP grubunda 6. hafta ortalama AAAS skoru 85.5±4.2 ve 6. ay skoru 90.6±2.6; steroid grubunda ise, sırasıyla, 75.3±4.8 ve 80.3±4.7 bulundu (p<0.001). Altıncı hafta ve 6. ay sonunda TZP grubunun ortalama GAS skoru (2.4±0.8 ve 1±0.8) steroid grubundan (4±1.1 ve 2.6±0.9) istatistiksel olarak anlamlı derecede farklı idi (p<0.001). TZP grubunun AAAS ve GAS skorlarındaki değişimin steroid grubuna kıyasla anlamlı şekilde yüksek olduğu kaydedildi (p<0.001).

Çıkarımlar: Kronik plantar fasiit tedavisinde TZP uygulaması steroid enjeksiyonuna göre ağrı ve fonksiyonel sonuçlar üzerinde daha etkili bir yöntemdir.

References

  • League AC. Current concepts review: plantar fasciitis. Foot Ankle Int 2008;29:358-66. CrossRef
  • Crawford F, Thomson C. Interventions for treat- ing plantar heel pain. Cochrane Database Syst Rev 2010;1:CD000416.
  • Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for Plantar fasciitis: a matched case-control study. J Bone Joint Surg Am 2003;85-A:872-7.
  • Scher DL, Belmont PJ Jr, Bear R, Mountcastle SB, Orr JD, Owens BD. The incidence of plantar fasciitis in the United States military. J Bone Joint Surg Am 2009;91:2867-72.
  • Jarde O, Diebold P, Havet E, Boulu G, Vernois J. Degen- erative lesions of the plantar fascia: surgical treatment by fasciectomy and excision of the heel spur. A report on 38 cases. Acta Orthop Belg 2003;69:267-74.
  • Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a de- generative process (fasciosis) without inflammation. J Am Podiatr Med Assoc 2003;93:234-7. CrossRef
  • Healey K, Chen K. Plantar fasciitis: current diagnos- tic modalities and treatments. Clin Podiatr Med Surg 2010;27:369-80. CrossRef
  • Davis PF, Severud E, Baxter DE. Painful heel syn- drome: results of nonoperative treatment. Foot Ankle Int 1994;15:531-5. CrossRef
  • Gill LH, Kiebzak GM. Outcome of nonsurgical treatment for plantar fasciitis. Foot Ankle Int 1996;17:527-32. CrossRef
  • Sánchez M, Anitua E, Orive G, Mujika I, Andia I. Plate- let-rich therapies in the treatment of orthopaedic sport injuries. Sports Med 2009;39:345-54. CrossRef
  • Barrett SL, Erredge SE. Growth factors for chronic plan- tar fasciitis? Podiatry Today 2004;17:36-42.
  • Akşahin E, Doğruyol D, Yüksel HY, Hapa O, Doğan O, Celebi L, et al. The comparison of the effect of cortico- steroids and platelet-rich plasma (PRP) for the treat- ment of plantar fasciitis. Arch Orthop Trauma Surg 2012;132:781-5. CrossRef
  • Ragab EM, Othman AM. Platelets rich plasma for treat- ment of chronic plantar fasciitis. Arch Orthop Trauma Surg 2012;132:1065-70. CrossRef
  • Martinelli N, Marinozzi A, Carnì S, Trovato U, Bianchi A, Denaro V. Platelet-rich plasma injections for chronic plantar fasciitis. Int Orthop 2013;37:839-42. CrossRef
  • de Vos RJ, van Veldhoven PL, Moen MH, Weir A, Tol JL, Maffulli N. Autologous growth factor injections in chronic tendinopathy: a systematic review. Br Med Bull 2010;95:63-77. CrossRef
  • Castillo TN, Pouliot MA, Kim HJ, Dragoo JL. Com- parison of growth factor and platelet concentration from commercial platelet-rich plasma separation systems. Am J Sports Med 2011;39:266-71. CrossRef
  • Anitua E. Plasma rich in growth factors: preliminary re- sults of use in the preparation of future sites for implants. Int J Oral Maxillofac Implants 1999;14:529-35.
  • Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT. Au- tologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost 2004;91:4-15.
  • Maffulli N, Del Buono A. Platelet plasma rich products in musculoskeletal medicine: any evidence? Surgeon 2012;10:148-50. CrossRef
  • Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myer- son MS, Sanders M. Clinical rating systems for the ankle- hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 1994;15:349-53. CrossRef
  • Crawford F, Atkins D, Young P, Edwards J. Steroid injec- tion for heel pain: evidence of short-term effectiveness. A randomized controlled trial. Rheumatology (Oxford) 1999;38:974-7. CrossRef
  • Acevedo JI, Beskin JL. Complications of plantar fascia rupture associated with corticosteroid injection. Foot An- kle Int 1998;19:91-7. CrossRef
  • Buccilli TA Jr, Hall HR, Solmen JD. Sterile abscess forma- tion following a corticosteroid injection for the treatment of plantar fasciitis. J Foot Ankle Surg 2005;44:466-8. CrossRef
  • Gidumal R, Evanski P. Calcaneal osteomyelitis following steroid injection: a case report. Foot Ankle 1985;6:44-6.
  • Lucarelli E, Beccheroni A, Donati D, Sangiorgi L, Cenac- chi A, Del Vento AM, et al. Platelet-derived growth fac- tors enhance proliferation of human stromal stem cells. Biomaterials 2003;24:3095-100. CrossRef
  • Kajikawa Y, Morihara T, Sakamoto H, Matsuda K, Os- hima Y, Yoshida A, et al. Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing. J Cell Physiol 2008;215:837-45. CrossRef
  • Alsousou J, Thompson M, Hulley P, Noble A, Willett K. The biology of platelet-rich plasma and its application in trauma and orthopaedic surgery: a review of the literature. J Bone Joint Surg Br 2009;91:987-96. CrossRef
  • Mishra A, Woodall J Jr, Vieira A. Treatment of tendon and muscle using platelet-rich plasma. Clin Sports Med 2009;28:113-25. CrossRef
  • Baksh N, Hannon CP, Murawski CD, Smyth NA, Ken- nedy JG. Platelet-rich plasma in tendon models: a sys- tematic review of basic science literature. Arthroscopy 2013;29:596-607. CrossRef
  • Andia I, Sánchez M, Maffulli N. Joint pathology and platelet-rich plasma therapies. Expert Opin Biol Ther 2012;12:7-22. CrossRef
  • Graziani F, Ivanovski S, Cei S, Ducci F, Tonetti M, Gabri- ele M. The in vitro effect of different PRP concentrations on osteoblasts and fibroblasts. Clin Oral Implants Res 2006;17:212-9. CrossRef
  • Pietrzak WS, Eppley BL. Platelet rich plasma: biology and new technology. J Craniofac Surg 2005;16:1043-54.
  • Ferrari M, Zia S, Valbonesi M, Henriquet F, Venere G, Spagnolo S, et al. A new technique for hemodilution, preparation of autologous platelet-rich plasma and intra- operative blood salvage in cardiac surgery. Int J Artif Or- gans 1987;10:47-50.
  • Mei-Dan O, Mann G, Maffulli N. Platelet-rich plasma: any substance into it? Br J Sports Med 2010;44:618-9.

Comparison of platelet-rich plasma and steroid injection in the treatment of plantar fasciitis

Year 2014, Volume: 48 Issue: 6, 667 - 672, 16.01.2015
https://doi.org/10.3944/AOTT.2014.13.0142

Abstract

Objective: The aim of this study was to compare the effects of platelet-rich plasma (PRP) and steroid injections in patients diagnosed with plantar fasciitis.

Methods: A total of 50 patients with chronic plantar fasciitis were included in the study and divided into 2 groups. In the PRP group (n=25), PRP taken from the patients’ blood was activated using calcium chloride and injected in a single dose. In the steroid group (n=25), a single dose methylprednisolone with local anesthetic injection was given. Clinical evaluation was made using the American Foot and Ankle Score (AFAS) and the visual analog scale (VAS).

Results: No complications were seen in any patients. Mean AFAS was 85.5±4.2 at 6 weeks and 90.6±2.6 at 6 months in the PRP group and 75.3±4.8 and 80.3±4.7, respectively, in the steroid group (p<0.001). The difference in the mean VAS between the PRP group (2.4±0.8 and 1±0.8) and the steroid group (4±1.1 and 2.6±0.9) at the 6th week and 6th month was statistically significant (p<0.001). Changes in AFAS and VAS scores were significantly higher in the PRP group (p<0.001).

Conclusion: The application of PRP appears to be more effective than steroid injection in terms of pain and functional results in the treatment of chronic plantar fasciitis.

References

  • League AC. Current concepts review: plantar fasciitis. Foot Ankle Int 2008;29:358-66. CrossRef
  • Crawford F, Thomson C. Interventions for treat- ing plantar heel pain. Cochrane Database Syst Rev 2010;1:CD000416.
  • Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for Plantar fasciitis: a matched case-control study. J Bone Joint Surg Am 2003;85-A:872-7.
  • Scher DL, Belmont PJ Jr, Bear R, Mountcastle SB, Orr JD, Owens BD. The incidence of plantar fasciitis in the United States military. J Bone Joint Surg Am 2009;91:2867-72.
  • Jarde O, Diebold P, Havet E, Boulu G, Vernois J. Degen- erative lesions of the plantar fascia: surgical treatment by fasciectomy and excision of the heel spur. A report on 38 cases. Acta Orthop Belg 2003;69:267-74.
  • Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a de- generative process (fasciosis) without inflammation. J Am Podiatr Med Assoc 2003;93:234-7. CrossRef
  • Healey K, Chen K. Plantar fasciitis: current diagnos- tic modalities and treatments. Clin Podiatr Med Surg 2010;27:369-80. CrossRef
  • Davis PF, Severud E, Baxter DE. Painful heel syn- drome: results of nonoperative treatment. Foot Ankle Int 1994;15:531-5. CrossRef
  • Gill LH, Kiebzak GM. Outcome of nonsurgical treatment for plantar fasciitis. Foot Ankle Int 1996;17:527-32. CrossRef
  • Sánchez M, Anitua E, Orive G, Mujika I, Andia I. Plate- let-rich therapies in the treatment of orthopaedic sport injuries. Sports Med 2009;39:345-54. CrossRef
  • Barrett SL, Erredge SE. Growth factors for chronic plan- tar fasciitis? Podiatry Today 2004;17:36-42.
  • Akşahin E, Doğruyol D, Yüksel HY, Hapa O, Doğan O, Celebi L, et al. The comparison of the effect of cortico- steroids and platelet-rich plasma (PRP) for the treat- ment of plantar fasciitis. Arch Orthop Trauma Surg 2012;132:781-5. CrossRef
  • Ragab EM, Othman AM. Platelets rich plasma for treat- ment of chronic plantar fasciitis. Arch Orthop Trauma Surg 2012;132:1065-70. CrossRef
  • Martinelli N, Marinozzi A, Carnì S, Trovato U, Bianchi A, Denaro V. Platelet-rich plasma injections for chronic plantar fasciitis. Int Orthop 2013;37:839-42. CrossRef
  • de Vos RJ, van Veldhoven PL, Moen MH, Weir A, Tol JL, Maffulli N. Autologous growth factor injections in chronic tendinopathy: a systematic review. Br Med Bull 2010;95:63-77. CrossRef
  • Castillo TN, Pouliot MA, Kim HJ, Dragoo JL. Com- parison of growth factor and platelet concentration from commercial platelet-rich plasma separation systems. Am J Sports Med 2011;39:266-71. CrossRef
  • Anitua E. Plasma rich in growth factors: preliminary re- sults of use in the preparation of future sites for implants. Int J Oral Maxillofac Implants 1999;14:529-35.
  • Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT. Au- tologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost 2004;91:4-15.
  • Maffulli N, Del Buono A. Platelet plasma rich products in musculoskeletal medicine: any evidence? Surgeon 2012;10:148-50. CrossRef
  • Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myer- son MS, Sanders M. Clinical rating systems for the ankle- hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 1994;15:349-53. CrossRef
  • Crawford F, Atkins D, Young P, Edwards J. Steroid injec- tion for heel pain: evidence of short-term effectiveness. A randomized controlled trial. Rheumatology (Oxford) 1999;38:974-7. CrossRef
  • Acevedo JI, Beskin JL. Complications of plantar fascia rupture associated with corticosteroid injection. Foot An- kle Int 1998;19:91-7. CrossRef
  • Buccilli TA Jr, Hall HR, Solmen JD. Sterile abscess forma- tion following a corticosteroid injection for the treatment of plantar fasciitis. J Foot Ankle Surg 2005;44:466-8. CrossRef
  • Gidumal R, Evanski P. Calcaneal osteomyelitis following steroid injection: a case report. Foot Ankle 1985;6:44-6.
  • Lucarelli E, Beccheroni A, Donati D, Sangiorgi L, Cenac- chi A, Del Vento AM, et al. Platelet-derived growth fac- tors enhance proliferation of human stromal stem cells. Biomaterials 2003;24:3095-100. CrossRef
  • Kajikawa Y, Morihara T, Sakamoto H, Matsuda K, Os- hima Y, Yoshida A, et al. Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing. J Cell Physiol 2008;215:837-45. CrossRef
  • Alsousou J, Thompson M, Hulley P, Noble A, Willett K. The biology of platelet-rich plasma and its application in trauma and orthopaedic surgery: a review of the literature. J Bone Joint Surg Br 2009;91:987-96. CrossRef
  • Mishra A, Woodall J Jr, Vieira A. Treatment of tendon and muscle using platelet-rich plasma. Clin Sports Med 2009;28:113-25. CrossRef
  • Baksh N, Hannon CP, Murawski CD, Smyth NA, Ken- nedy JG. Platelet-rich plasma in tendon models: a sys- tematic review of basic science literature. Arthroscopy 2013;29:596-607. CrossRef
  • Andia I, Sánchez M, Maffulli N. Joint pathology and platelet-rich plasma therapies. Expert Opin Biol Ther 2012;12:7-22. CrossRef
  • Graziani F, Ivanovski S, Cei S, Ducci F, Tonetti M, Gabri- ele M. The in vitro effect of different PRP concentrations on osteoblasts and fibroblasts. Clin Oral Implants Res 2006;17:212-9. CrossRef
  • Pietrzak WS, Eppley BL. Platelet rich plasma: biology and new technology. J Craniofac Surg 2005;16:1043-54.
  • Ferrari M, Zia S, Valbonesi M, Henriquet F, Venere G, Spagnolo S, et al. A new technique for hemodilution, preparation of autologous platelet-rich plasma and intra- operative blood salvage in cardiac surgery. Int J Artif Or- gans 1987;10:47-50.
  • Mei-Dan O, Mann G, Maffulli N. Platelet-rich plasma: any substance into it? Br J Sports Med 2010;44:618-9.
There are 34 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Ferhat Say This is me

Deniz Gurler This is me

Erkan Inkaya This is me

Murat Bulbul This is me

Publication Date January 16, 2015
Published in Issue Year 2014 Volume: 48 Issue: 6

Cite

APA Say, F., Gurler, D., Inkaya, E., Bulbul, M. (2015). Comparison of platelet-rich plasma and steroid injection in the treatment of plantar fasciitis. Acta Orthopaedica Et Traumatologica Turcica, 48(6), 667-672. https://doi.org/10.3944/AOTT.2014.13.0142
AMA Say F, Gurler D, Inkaya E, Bulbul M. Comparison of platelet-rich plasma and steroid injection in the treatment of plantar fasciitis. Acta Orthopaedica et Traumatologica Turcica. January 2015;48(6):667-672. doi:10.3944/AOTT.2014.13.0142
Chicago Say, Ferhat, Deniz Gurler, Erkan Inkaya, and Murat Bulbul. “Comparison of Platelet-Rich Plasma and Steroid Injection in the Treatment of Plantar Fasciitis”. Acta Orthopaedica Et Traumatologica Turcica 48, no. 6 (January 2015): 667-72. https://doi.org/10.3944/AOTT.2014.13.0142.
EndNote Say F, Gurler D, Inkaya E, Bulbul M (January 1, 2015) Comparison of platelet-rich plasma and steroid injection in the treatment of plantar fasciitis. Acta Orthopaedica et Traumatologica Turcica 48 6 667–672.
IEEE F. Say, D. Gurler, E. Inkaya, and M. Bulbul, “Comparison of platelet-rich plasma and steroid injection in the treatment of plantar fasciitis”, Acta Orthopaedica et Traumatologica Turcica, vol. 48, no. 6, pp. 667–672, 2015, doi: 10.3944/AOTT.2014.13.0142.
ISNAD Say, Ferhat et al. “Comparison of Platelet-Rich Plasma and Steroid Injection in the Treatment of Plantar Fasciitis”. Acta Orthopaedica et Traumatologica Turcica 48/6 (January 2015), 667-672. https://doi.org/10.3944/AOTT.2014.13.0142.
JAMA Say F, Gurler D, Inkaya E, Bulbul M. Comparison of platelet-rich plasma and steroid injection in the treatment of plantar fasciitis. Acta Orthopaedica et Traumatologica Turcica. 2015;48:667–672.
MLA Say, Ferhat et al. “Comparison of Platelet-Rich Plasma and Steroid Injection in the Treatment of Plantar Fasciitis”. Acta Orthopaedica Et Traumatologica Turcica, vol. 48, no. 6, 2015, pp. 667-72, doi:10.3944/AOTT.2014.13.0142.
Vancouver Say F, Gurler D, Inkaya E, Bulbul M. Comparison of platelet-rich plasma and steroid injection in the treatment of plantar fasciitis. Acta Orthopaedica et Traumatologica Turcica. 2015;48(6):667-72.