title: Platelet-rich plasma efficacy versus corticosteroid injection treatment for chronic severe plantar fasciitis.
abstract: BACKGROUND
  Chronic plantar fasciitis is a common orthopedic condition that can prove difficult to successfully treat. In this study, autologous platelet-rich plasma (PRP), a concentrated bioactive blood component rich in cytokines and growth factors, was compared to traditional cortisone injection in the treatment of chronic cases of plantar fasciitis resistant to traditional nonoperative management.
  
  
  METHODS
  Forty patients (23 females and 17 males) with unilateral chronic plantar fasciitis that did not respond to a minimum of 4 months of standardized traditional nonoperative treatment modalities were prospectively randomized and treated with either a single ultrasound guided injection of 3 cc PRP or 40 mg DepoMedrol cortisone. American Orthopedic Foot and Ankle Society (AOFAS) hindfoot scoring was completed for all patients immediately prior to PRP or cortisone injection (pretreatment = time 0) and at 3, 6, 12, and 24 months following injection treatment. Baseline pretreatment radiographs and MRI studies were obtained in all cases to confirm the diagnosis of plantar fasciitis.
  
  
  RESULTS
  The cortisone group had a pretreatment average AOFAS score of 52, which initially improved to 81 at 3 months posttreatment but decreased to 74 at 6 months, then dropped to near baseline levels of 58 at 12 months, and continued to decline to a final score of 56 at 24 months. In contrast, the PRP group started with an average pretreatment AOFAS score of 37, which increased to 95 at 3 months, remained elevated at 94 at 6 and 12 months, and had a final score of 92 at 24 months.
  
  
  CONCLUSIONS
  PRP was more effective and durable than cortisone injection for the treatment of chronic recalcitrant cases of plantar fasciitis.
  
  
  METHODS
  Level I, prospective randomized comparative series.
authors.affiliation: Nantucket Cottage Hospital Partners Healthcare System, Nantucket, MA, USA.
authors.forename: Raymond Rocco
authors.initials: RR
authors.lastname: Monto
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003348:Cortisone / Q000627:therapeutic use*; D003952:Diagnostic Imaging; D036981:Fasciitis, Plantar / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D003348:Cortisone
keywords: PRP; cortisone injection; heel pain; plantar fasciitis; platelet-rich plasma