Plantar Fasiit Tedavisinde Trombosit Zengin Plazma ve Ekstrakorporeal Şok Dalga Tedavisinin Etkinliğinin Karşılaştırılması

Yıl 2020, Cilt: 4 Sayı: 1, 3 - 9, 02.03.2020

Ümit Yalçın

https://doi.org/10.30565/medalanya.566188

Cited By: 4

Öz

Amaç: Plantar fasiit (PF), topuk ağrısının en sık görülen nedenlerinden biridir. PF tedavisi için çeşitli konservatif yöntemler vardır. Hastaların yaklaşık% 10'u konservatif yöntemlere dirençlidir ve bu nedenle cerrahi işlemlere tabi tutulur. Bu çalışmada PF hastalarında trombositten zengin plazma (PRP) enjeksiyonunun ekstrakorporeal şok dalgası tedavisinin (ESWT) etkinliği ile karşılaştırılması amaçlandı.

Hastalar ve Yöntemler: Çalışmaya en az 3 aydır şikayeti olan ve steroid olmayan antienflamatuar ilaçlara ve germe egzersizlerine direnç gösteren 58 hasta (40 kadın) alındı. PRP enjeksiyonu (n = 29) veya ESWT (n = 29) uygulanan hastalar, tedavi öncesi ve tedaviden sonraki 3. ayda, Ağrı şiddeti, Görsel Analog Skala (VAS) ve İşlevsellik ise, Ayak Fonksiyon İndeksi (FFI) ile değerlendirildi.

Bulgular: Her iki grupta da, tedavi sonrası 3. ayda VAS ve FFI skorlarında tedavi öncesi skorlara göre anlamlı bir iyileşme gözlendi. PRP grubunda VAS ve FFI skorlarındaki iyileşme ESWT grubuna göre anlamlı olarak daha yüksekti (P < 0.05).

Sonuç: PRP, PF hastalarında ağrı ve fonksiyonel skorları iyileştirmede ESWT'den daha etkili bir yöntem olabilir. Ancak, bu konuda daha fazla çalışmaya ihtiyaç var.

Anahtar Kelimeler

Trombosit bakımından zengin plazma, plantar fasiit, ekstrakorporeal şok dalgası tedavisi, ağrı, enjeksiyon, tedavi, ayak eklemleri, tamamlayıcı tıp

Comparison of efficacy of platelet-rich plasma and extracorporeal shock-wave therapy on pain and functional capacity in patients with Plantar Fasciitis

Öz

Aim: Plantar Fasciitis (PF) is one of the most common causes of heel pain. There are various conservative methods for the treatment of PF. Nearly 10% of the patients are refractory to the conservative methods and thus undergo surgical procedures. This study aimed to compare the efficacy of platelet-rich plasma (PRP) injection with that of extracorporeal shock-wave therapy (ESWT) in PF patients.

Patients and Methods: The study included 58 patients (40 females), who had complaints for at least 3 months and were refractory to the non-steroidal anti-inflammatory drugs and stretching exercises. The patients who underwent PRP injection (n=29) and ESWT (n=29) were evaluated regarding pain severity by Visual Analogue Scale (VAS) and functionality by Foot Function Index (FFI) both before and at the 3rd month after treatment.

Results: In both groups, a significant improvement was observed in the VAS and FFI scores at the 3rd month after the treatment as compared with the pretreatment scores. The improvement in the VAS and FFI scores was significantly greater in the PRP group than in the ESWT group (P < 0.05).

Conclusions: PRP can be a more effective method than ESWT in improving pain and functional scores in PF patients. However, further studies are needed on this issue.

Anahtar Kelimeler

: Platelet-rich plasma, plantar fasciitis, extracorporeal shock-wave therapy, pain, injection, therapy, foot joints, complementary medicine

Kaynakça

• 1. Neufeld SK, Cerrato R. Plantar Fasciitis: Evaluation and treatment. J Am Acad Orthop Surg. 2008;16(6):338–46. PMID:18524985
• 2. Lim AT, How CH, Tan B. Management of Plantar Fasciitis in the outpatient setting. Singapore Med J. 2016;57(4):168-71. PMID:27075037
• 3. Seligman DA, Dawson DR. Customized heel pads and soft orthotics to treat heel pain and Plantar Fasciitis. Arch Phys Med Rehabil. 2003;84(10):1564–67. PMID:14586928
• 4. Davis PF, Severud E, Baxter DE. Painful heel syndrome: Results of nonoperative treatment. Foot Ankle Int. 1994;15(10): 531–55. PMID:7834059
• 5. Othman AM, Ragab EM. Endoscopic Plantar fasciotomy versus extracorporeal shock wave therapy for treatment of chronic Plantar Fasciitis. Arch Orthop Trauma Surg. 2010; 130(11):1343–7. PMID:20033696
• 6. Buchbinder R, Ptasznik R, Gordon J, Buchanan J, Prabaharan V, Forbes A. Ultrasound-guided extracorporeal shock wave therapy for Plantar Fasciitis: A randomized controlled trial. JAMA. 2002;288(11):1364–72. PMID:12234230
• 7. Sánchez M, Anitua E, Orive G, Mujika I, Andia I. Platelet-rich therapies in the treatment of orthopaedic sport injuries. Sports Med. 2009;39(5):345–54. PMID:19402740
• 8. Maffulli N, Del Buono A. Platelet plasma rich products in musculoskeletal medicine: Any evidence? Surgeon. 2012;10(3):148–50. PMID:22525416
• 9. SooHoo NF, Samimi DB, Vyas RM, Botzler T. Evaluation of the validity of the Foot Function Index in measuring outcomes in patients with foot and ankle disorders. Foot Ankle Int. 2006;27(1):38–42. PMID:16442027
• 10. Yalıman A, Şen Eİ, Eskiyurt N, Budiman-Mak E. Turkish translation and adaptation of Foot Function Index in patients with Plantar Fasciitis. Turk J Phys Med Rehab. 2014;60(3):212-22. DOI: 10.5152/tftrd.2014.28086
• 11. Cotchett MP, Landorf KB, Munteanu SE. Effectiveness of dry needling and injections of myofascial trigger points associated with Plantar heel pain: A systematic review. J Foot Ankle Res. 2010;3:18. PMID:20807448
• 12. Tiwari M, Bhargava R. Platelet rich plasma therapy: A comparative effective therapy with promising results in Plantar Fasciitis. J Clin Orthop Trauma. 2013;4(1):31–5. PMID:26403772
• 13. De Mos M., van der Windt A.E., Jahr H. Can platelet-rich plasma enhance tendon repair? A cell culture study. Am J Sports Med. 2008;36(6):1171–8. PMID:18326832
• 14. Lyras D.N., Kazakos K., Agrogiannis G. Experimental study of tendon healing early phase: is IGF-1 expression influenced by platelet rich plasma gel? Orthop Traumatol Surg Res. 2010;96(4):381–387. PMID:20452307
• 15. Kajikawa Y, Morihara T, Sakamoto H, Matsuda K, Oshima Y, Yoshida A. et al. Platelet-rich Plasma Enhances the Initial Mobilization of Circulation-Derived Cells for Tendon Healing. J Cell Physiol. 2008;215(3):837–45. PMID:18181148
• 16. Baksh N, Hannon CP, Murawski CD, Smyth NA, Kennedy JG. Platelet-rich plasma in tendon models: A systematic review of basic science literature. Arthroscopy. 2013;29(3):596–607. PMID:23352397
• 17. Graziani F, Ivanovski S, Cei S, Ducci F, Tonetti M, Gabriele M. The in vitro effect of different PRP concentrations on osteoblasts and fibroblasts. Clin Oral Implants Res. 2006;17(2):212-19. PMID:16584418
• 18. Martinelli N, Marinozzi A, Carni S, Trovato U, Bianchi A, Denaro V. Platelet-rich plasma injections for chronic Plantar Fasciitis. Int Orthop. 2013;37(5):839–42. PMID:23250352
• 19. Liang HW, Wang TG, Chen WS, Hou SM. Thinner Plantar fascia predicts decreased pain after extracorporeal shock wave therapy. Clin Orthop Relat Res. 2007;460:219–25. PMID:17353798
• 20. Gerdesmeyer L, Frey C, Vester J, Maier M, Weil L, Jr, Weil L, Sr, et al. Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant Plantar Fasciitis: Results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med. 2008;36(11):2100–9. PMID:18832341
• 21. Wu YH, Lun JJ, Chen WS, Chong FC. The electrophysiological and functional effect of shock wave on peripheral nerves. Conf Proc IEEE Eng Med Biol Soc. 2007;2007:2369–72.
• 22. Cutts S, Obi N, Pasapula C, Chan W. Plantar Fasciitis. Ann R Coll Surg Engl. 2012;94(8):539–42. PMID:23131221
• 23. Aqil A, Siddiqui MR, Solan M, Redfern DJ, Gulati V, Cobb JP. Extracorporeal shock wave therapy is effective in treating chronic Plantar Fasciitis: A meta-analysis of RCTs. Clin Orthop Relat Res. 2013;471(11):3645–52. PMID:23813184
• 24. Chew KT, Leong D, Lin CY, Lim KK, Tan B. Comparison of autologous conditioned plasma injection, extracorporeal shockwave therapy, and conventional treatment for Plantar Fasciitis: A randomized trial. PM R. 2013;5(12):1035–43. PMID:23973504
• 25. Li H, Lv H, Lin T. Comparison of efficacy of eight treatments for Plantar Fasciitis: A network meta-analysis. J Cell Physiol. 2018;234(1):860–70. PMID:30078188