title: Short-term efficacy and safety of hyaluronic acid injection for plantar fasciopathy.
abstract: OBJECTIVE
  Plantar fasciopathy is the most common cause of plantar heel pain and is considered to be a type of enthesopathy. The short-term efficacy, safety, and dose-response relationship of high-molecular-weight hyaluronic acid (HA) was investigated in patients with plantar fasciopathy.
  
  
  METHODS
  In this multicenter, prospective, randomized, double-blind, placebo-controlled trial, 168 patients with persistent pain from plantar fasciopathy for more than 12 weeks were randomly assigned to receive 2.5 mL of 1% HA (H-HA), 0.8 mL of 1% HA (L-HA), or 2.5 mL of 0.01% HA (control group) once a week for 5 weeks. The primary endpoint was improvement in visual analogue scale (VAS) score for pain from baseline to week 5.
  
  
  RESULTS
  The VAS scores (least squares mean ± standard error) in each group decreased gradually after the start of treatment, a change of -3.3 ± 0.3 cm for the H-HA group, -2.6 ± 0.3 cm for the L-HA group, and -2.4 ± 0.3 cm for the control group, with the H-HA group improving significantly more than the control group (P = 0.029). No serious adverse events were reported. There was no difference between the groups in the incidence rates of adverse drug reactions.
  
  
  CONCLUSIONS
  The administration of five injections of high-molecular-weight HA is an effective treatment with no serious adverse drug reactions and is a conservative treatment option for plantar fasciopathy. This treatment contributed to alleviation of pain in patients with plantar fasciopathy and improvement in their activities of daily living.
  
  
  METHODS
  I.
authors.affiliation: Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan. kumakumat@aol.com.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Kumai
authors.affiliation: Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Samoto
authors.affiliation: Agatsuma Higashi Orthopaedic Clinic, 756-1, Isemachi, Nakanojo-machi Agatsuma-gun, Gumma, 377-0423, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hasegawa
authors.affiliation: Ishii Orthopaedic and Rehabilitation Clinic, 1089-1, Shimo-Oshi, Gyoda-shi, Saitama, 361-0037, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Noguchi
authors.affiliation: Shiranita Orthopaedic Clinic, 1-6-13, Shiragane, Kokurakita-ku Kitakyushu-shi, Fukuoka, 802-0074, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiranita
authors.affiliation: Shiraishi Orthopaedic Pain Clinic, 5-41-16, Nakakasai, Edogawa-ku, Tokyo, 134-0083, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Shiraishi
authors.affiliation: Department of Orthopaedic Surgery, Ken-Ai Memorial Hospital, 1191, Kimori, Onga-cho, Onga-gun, Fukuoka, 811-4313, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ikeda
authors.affiliation: Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sugimoto
authors.affiliation: Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Takakura
mesh_terms: D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D036981:Fasciitis, Plantar / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid
keywords: Double-blind; Enthesopathy; Heel pain; Hyaluronic acid; Plantar fascia; Randomized controlled trial