Platelet-Rich Plasma Versus Corticosteroids in the Treatment of Plantar Fasciitis: A Systematic Review and Meta-analysis.

Abstract

Objective: This study aims to compare the efficacy of platelet-rich plasma and corticosteroids in treating plantar fasciitis, focusing on pain relief, foot function, and plantar fascia thickness to identify the optimal treatment approach.

Design: A comprehensive search of medical databases was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, utilizing an extensive keyword strategy. Inclusion criteria encompassed prospective randomized controlled trials involving adult patients with plantar fasciitis treated with local platelet-rich plasma or corticosteroid injections, specifically assessing outcomes such as the visual analog scale, American Orthopedic Foot and Ankle Society scores, and plantar fascia thickness.

Results: The meta-analysis included 24 randomized controlled trials with 1653 participants. Platelet-rich plasma injections yielded significantly better visual analog scale scores compared to corticosteroid injections at 3 mos ( P = 0.03) and 6 mos ( P < 0.001), with no significant differences at 1 mo ( P = 0.12) and 12 mos ( P = 0.08). American Orthopedic Foot and Ankle Society scores demonstrated that platelet-rich plasma was superior to corticosteroid at 3 ( P = 0.05), 6 ( P < 0.001), and 12 mos ( P < 0.001), with no significant differences at 1 mo ( P = 0.31). Regarding plantar fascia thickness, there were no significant differences between platelet-rich plasma and corticosteroid at 1-1.5 mos ( P = 0.18), 3 mos ( P = 0.64), and 6 mos ( P = 0.05).

Conclusions: Platelet-rich plasma injections offer superior pain control compared to corticosteroids in the medium term (3-6 mos) but not in the short term or at 1 yr.