Plantar fasiit tedavisinde trombositten zengin plazma ve steroid enjeksiyonunun karşılaştırması

Yıl 2014, , 667 - 672, 16.01.2015

Ferhat Say Deniz Gurler Erkan Inkaya Murat Bulbul

https://doi.org/10.3944/AOTT.2014.13.0142

Öz

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.

Anahtar Kelimeler

Büyüme faktörü; plantar fasiit; steroid; trombositten zengin plazma.

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

Öz

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.

Anahtar Kelimeler

Growth factor, plantar fasciitis, platelet-rich plasma, steroid

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