title: Comparison of autologous conditioned plasma injection, extracorporeal shockwave therapy, and conventional treatment for plantar fasciitis: a randomized trial.
abstract: OBJECTIVE
  To evaluate the efficacy of autologous conditioned plasma (ACP) compared with extracorporeal shockwave (ESWT) and conventional treatments for plantar fasciitis.
  
  
  METHODS
  Randomized trial.
  
  
  METHODS
  Sports medicine center in a tertiary care hospital.
  
  
  METHODS
  Fifty-four subjects (age range, 29-71 years) with unilateral chronic plantar fasciitis with more than 4 months of symptoms.
  
  
  METHODS
  Subjects randomized to 3 groups: 19 to ACP and conventional treatment (ACP group), 19 to ESWT and conventional treatment (ESWT group), and 16 to conventional treatment alone. Conventional treatment included stretching exercises and orthotics if indicated.
  
  
  METHODS
  Outcomes were pain-Visual Analog Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, and ultrasound plantar fascia thickness assessed at baseline before treatment and at 1 month, 3 months, and 6 months after treatment.
  
  
  RESULTS
  VAS, AOFAS ankle-hindfoot scale, and plantar fascia thickness improved in all groups. Significant VAS pain score improvements in the ACP group compared with conventional treatment at month 1 (P = .037) and for the ESWT group compared with conventional treatment at months 1, 3, and 6 (P = .017, P = .022, and P = .042). The AOFAS ankle-hindfoot scale score improved in the ACP group at months 3 and 6 (P = .004 and P = .013) and, for the ESWT group, at months 1 and 3 (P = .011 and P = .003) compared with conventional treatment. Significant improvements in plantar fascia thickness were seen in the ACP group at months 1 and 3 compared with conventional treatments (P = .015 and P = .014) and at months 3 and 6 compared with the ESWT group (P = .019 and P = .027). No adverse events reported.
  
  
  CONCLUSIONS
  Treatment of plantar fasciitis with ACP or ESWT plus conventional treatments resulted in improved pain and functional outcomes compared with conventional treatment alone. There was no significant difference between ACP and ESWT in terms of VAS and AOFAS ankle-hindfoot scale improvements, although the ACP group demonstrated greater reductions in plantar fascia thickness.
authors: Changi Sports Medicine Centre, Changi General Hospital, Singapore(∗).
authors: Kelvin Tai Loon
authors: KT
authors: Chew
authors: Changi Sports Medicine Centre, Changi General Hospital, Singapore(†).
authors: Darren
authors: D
authors: Leong
authors: Changi Sports Medicine Centre, Changi General Hospital, Singapore 529889(‡). Electronic address: cindy.lin@post.harvard.edu.
authors: Cindy Y
authors: CY
authors: Lin
authors: Department of Orthopedic Surgery, Changi General Hospital (affiliation of K.K.L. when study was performed), Singapore; Synergy Orthopedic Group, Singapore(§).
authors: Kay Kiat
authors: KK
authors: Lim
authors: Changi Sports Medicine Centre, Changi General Hospital, Singapore(¶).
authors: Benedict
authors: B
authors: Tan
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D036981:Fasciitis, Plantar / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D053657:Platelet-Rich Plasma; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography