scholarly journals Long-term clinical results of autologous Platelet Rich Plasma (PRP) in recalcitrant plantar fasciitis

2021 ◽  
Vol 7 (1) ◽  
pp. 12-16
Author(s):  
Ankit Kumar Garg ◽  
Ranjeet Choudhary ◽  
Alok Chandra Agrawal ◽  
Anupam Pradip Inamdar ◽  
Shilp Verma
Keyword(s):  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Post Injection ◽  
Duration Of Symptoms ◽  
Low Level ◽  
Autologous Platelet Rich Plasma ◽  
The Mean ◽  
One Year ◽  
Autologous Platelet

In recent years, biologic therapies such as platelet-rich plasma (PRP) have gained prominence in multiple orthopedics degenerative tendinopathy and ligamental pathology. This research aimed to assess the clinical effectiveness of autologous platelet-rich plasma injection in cases of recalcitrant plantar fasciitis (RPF) over a long period.A prospective observational study was performed on RPF that did not experience pain relief after three months of conservative therapy. Under sterile conditions, inject approximately 3ml of platelet-rich plasma mixed with 0.5ml lignocaine into the maximum tender point of the heel. Visual Analogue Score for Pain, the American Orthopedics Foot, and Ankle Society (AOFAS) Ankle, and Hind Foot Score at one month, three months, six months, one year, and two years after injection.A total of 60 patients of RPF which 23 (38.33%) were male, and the rest 37 (61.66%) were female. The mean age was 45 ± 7.25 and the mean duration of symptoms was 7.4 ± 2.1months. The mean VAS score was 7.92 ± 1.2 at pre-injection, was progressively reduced post-injection to 5.61 ± 1.56 at one month, 3.1 ± .83 at three months, and 2.4 ± .68 at six months and remained at low level 2.5 ± .92 at one year and 2.7 ± .56 at two years. The mean AOFAS score was 56.92 ± 13.24 at pre-injection, was progressively increased post-injection to 66.41± 10.26 at one month, 78.31 ± 12.64 at three months, and 90.54 ± 10.71 at six months and remained at a low level 89.24 ± 8.92 at one year and 87.54 ±10.56 at two years. Mean VAS and AOFAS scores showed statistically significant pain reduction and functional improvements at successive follow-ups till 6month (p<.05); the improvement remained stable and did not change significantly until the last appointment at 2year follow-up (p > 0.05).The outcomes of autologous PRP injection in recalcitrant plantar fasciitis are reliable, stable, and predictable in both long- and short-term follow-up. PRP injection is safer and not associated with serious complications as in the case of steroid injection.

scholarly journals Intradiscal Injection of Autologous Platelet-Rich Plasma Releasate to Treat Discogenic Low Back Pain: A Preliminary Clinical Trial

2017 ◽  
Vol 11 (3) ◽  
pp. 380-389 ◽  
Author(s):  
Koji Akeda ◽  
Kohshi Ohishi ◽  
Koichi Masuda ◽  
Won C. Bae ◽  
Norihiko Takegami ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Platelet Rich Plasma ◽  
Low Back ◽  
Discogenic Low Back Pain ◽  
Intradiscal Injection ◽  
Autologous Platelet Rich Plasma ◽  
The Mean ◽  
Autologous Platelet

<sec><title>Study Design</title><p>Preliminary clinical trial.</p></sec><sec><title>Purpose</title><p>To determine the safety and initial efficacy of intradiscal injection of autologous platelet-rich plasma (PRP) releasate in patients with discogenic low back pain.</p></sec><sec><title>Overview of Literature</title><p>PRP, which is comprised of autologous growth factors and cytokines, has been widely used in the clinical setting for tissue regeneration and repair. PRP has been shown <italic>in vitro</italic> and <italic>in vivo</italic> to potentially stimulate intervertebral disc matrix metabolism.</p></sec><sec><title>Methods</title><p>Inclusion criteria for this study included chronic low back pain without leg pain for more than 3 months; one or more lumbar discs (L3/L4 to L5/S1) with evidence of degeneration, as indicated via magnetic resonance imaging (MRI); and at least one symptomatic disc, confirmed using standardized provocative discography. PRP releasate, isolated from clotted PRP, was injected into the center of the nucleus pulposus. Outcome measures included the use of a visual analog scale (VAS) and the Roland-Morris Disability Questionnaire (RDQ), as well as X-ray and MRI (T2-quantification).</p></sec><sec><title>Results</title><p>Data were analyzed from 14 patients (8 men and 6 women; mean age, 33.8 years). The average follow-up period was 10 months. Following treatment, no patient experienced adverse events or significant narrowing of disc height. The mean pain scores before treatment (VAS, 7.5±1.3; RDQ, 12.6±4.1) were significantly decreased at one month, and this was generally sustained throughout the observation period (6 months after treatment: VAS, 3.2±2.4, RDQ; 3.6±4.5 and 12 months: VAS, 2.9±2.8; RDQ, 2.8±3.9; <italic>p</italic>&lt;0.01, respectively). The mean T2 values did not significantly change after treatment.</p></sec><sec><title>Conclusions</title><p>We demonstrated that intradiscal injection of autologous PRP releasate in patients with low back pain was safe, with no adverse events observed during follow-up. Future randomized controlled clinical studies should be performed to systematically evaluate the effects of this therapy.</p></sec>

scholarly journals A comparative study between local injection of autologous platelet rich plasma and injection of corticosteroid in functional improvement of plantar fasciitis

2019 ◽  
Vol 6 (3) ◽  
pp. 653 ◽  
Author(s):  
Vithal Prakash Puri ◽  
Anil Kumar Gaur
Keyword(s):  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Tertiary Care ◽  
Functional Improvement ◽  
Significant Difference ◽  
Group A ◽  
Autologous Platelet Rich Plasma ◽  
Group B ◽  
Autologous Platelet

Background: Plantar fasciitis is a common cause of heel pain in adults. Although it is usually a self-limiting condition, the pain may become prolonged and severe enough to cause significant distress and disruption to the patient’s daily activities and work. The primary objective of the study was to evaluate and compare the effectiveness of autologous platelet rich plasma (PRP) and steroid injections in chronic cases of plantar fasciitis (PF).Methods: A prospective, randomized study was conducted from December 2013 to December 2015 amongst 60 patients with chronic PF were randomized prospectively in single tertiary care center in India. All the patients were enrolled according to inclusion criteria and divided into 2 groups i.e. group A (n=30) received PRP and group B (n=30) received corticosteroids injections. Roles and Maudsley score (RM Score) and Foot Function Index (FFI) was evaluated for all the included patients. The follow-up scheduled at 1 and 6 months after complete enrolment of patients.Results: Between both the groups, the significant difference was observed at 1 and 6 months follow-up from the baseline. At 1-month follow-up, statistically significant improvement in mean RM scores were seen in both the groups from baseline and when RM scores were compared between two groups, group B had statistically better mean scores. At 1-month follow-up there was no statistically significant difference between the mean FFI score values between two groups. At 6-month follow-up, statistically significant improvement in mean FFI scores were seen in both the groups, however when both groups were compared to each other, improvement in mean FFI scores was statistically better in group A as compared to group B.Conclusions: The present study concluded the use of PRP in chronic cases of plantar fasciitis seems more safe and effective in long term than the traditional treatment of steroid injection at different time period.

scholarly journals P303 Local Application of Autologous Platelet-rich Plasma leads to Sustained Healing of Crohn’s Perianal Fistulae – One Year follow-up Results from a Single Center Pilot Study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S331-S332
Author(s):  
D Podmanicky ◽  
M Jezberova ◽  
J Lucenicova ◽  
V Bak ◽  
B Kadleckova ◽  
...  
Keyword(s):  
Wound Repair ◽  
Platelet Rich Plasma ◽  
Complete Healing ◽  
End Point ◽  
Perianal Fistulae ◽  
Autologous Platelet Rich Plasma ◽  
One Year ◽  
Mri Score ◽  
Autologous Platelet

Abstract Background Failure of wound repair and dysregulated inflammation in considered to play a key role in the persistence of Crohn’s perianal fistulae (pCD). Few preliminary reports suggest that autologous platelet-rich plasma (PRP) can enhance wound repair and may be effective in treating pCD. Therefore, the aim of our study was to determine the efficacy of autologous PRP in the treatment of pCD. Methods A prospective, uncontrolled, single center study in a referral IBD center was conducted between July 2018 and March 2021. Adult Crohn′s disease patients with pCD failing on antibiotics, immune suppression and/or biologics were eligible for the study. All patients had non-cutting setons for a minimal period of 6 weeks prior study intervention. Autologous PRP was separated by centrifugation 60 ml of peripheral blood in Harvest SmartPrep© System at the time of operation. After the seton removing, internal openings were closed by PDS 2/0 single suture and PRP was injected close to internal openings and fistula tracts. Patients were examined at outpatient clinic at week 1, month 1, 3, 6 and 12. Any suspected side-effects of the treatment were noted. Treatment effect was assessed by perianal Crohn Disease Activity Index (PCDAI assessed at baseline, month 1, 3, 6, 12) and van Assche MRI score (assessed at baseline and month 6 and 12). The primary end-point was complete healing at month 6 defined as closure of all external fistula openings and absence of abscess on MRI. The secondary end-point was sustained response at month 12. Results In total, 25 patients (pts) with pCD were included (mean age 36 years, range 21-61; 15 men). The majority of pts were using antiTNF biologics (9 adalimumab, 9 infliximab), 4 pts were treated by ustekinumab, one by vedolizumab, two patients were on immunomodulators monotherapy. By March 2021, 24 patients finished the 6 months and 21 patients the 12 months follow-up. The primary end-point of complete healing at month 6 was reached by 18 out of 24 pts (75%). All but one patients with complete healing had persistent complete healing at 12 months follow-up. Baseline PCDAI (median 5, range 2-15) decreased significantly as early as at month 1 (median 1, range 0-8; p&lt;0.001) and remained further stable over 12 months. Van Assche MRI score decreased significantly from median of 9 (range 3-18) at baseline to 5 (range 0-18) and 5.5 (range 0-18) at month 6 (p=0.001) and 12 (p=0.03); respectively. Conclusion Local application of autologous platelet-rich plasma leads to rapid healing of difficult-to-treat Crohn’s perianal fistulae in 75% of patients and this effect is sustained up to minimal period of one year.

“ROLE OF AUTOLOGOUS PLATELET RICH PLASMA THERAPY IN TREATMENT OF PLANTAR FASCIITIS, A PROSPECTIVE STUDY.”

2021 ◽  
pp. 51-52
Author(s):  
Kashif Iqbal ◽  
Vivek Kumar ◽  
Himanshu Patel ◽  
Anurag Tiwari
Keyword(s):  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Case Series ◽  
Small Sample ◽  
Treatment Modalities ◽  
Post Injection ◽  
Plasma Therapy ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Plantar fasciitis is fairly common in orthopaedics out-patient department. Although, majority of the patients do well with conservative treatment, some patients continue to have painful feet despite a course of conservative management. These patients of plantar fasciitis are provided with other treatment modalities such as local corticosteroid but the chronic condition requires multiple dosages and are associated with adverse reaction. Autologous platelet rich plasma therapy is another modality for treatment of such cases and are not associated with adverse effects when compared with corticosteroid injection therapy. This prospective case series analyses the improvement of pain using visual analogue scale of plantar fasciitis patients treated with autologous platelet rich plasma over the course of 3 months. 30 patients were enrolled in the study. The mean VAS score at pre injection was 7.13 which signicantly reduced to 3.3 at 6 weeks post injection and 2.36 at 6 weeks post injection. There was signicant improvement in pain. This study is limited with small sample size and short follow up.

Local injection of Platelet Rich Plasma for Plantar Fasciitis

2021 ◽  
Vol 12 (3) ◽  
pp. 75-80
Author(s):  
Vishwas Sharad Phadke ◽  
Vaibhav Vinayak Antrolikar ◽  
Ajaykumar Ramlu Allamwar
Keyword(s):  
Cohort Study ◽  
Pain Relief ◽  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Plantar Fascia ◽  
Local Injection ◽  
Vas Score ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Background: Plantar fasciitis can be defined as inflammation at the insertion of plantar fascia and is thought most commonly due to overuse injury. It usually presents as sharp shooting heel pain which is worse in the morning. The location of pain is usually plantar surface of the foot and pain may radiate proximally in long standing and severe cases. In mild cases of plantar fasciitis non steroidal anti-inflammatory drugs and activity modification may be sufficient. Severe cases may require interventions such as night splints and orthotic devices which works by reducing loading of plantar fascia. Recently local injection of autologous platelet rich plasma is used by many researchers with promising results. Aims and Objectives: This prospective cohort study was undertaken to analyze the functional and clinical outcome in patients with plantar fasciitis who were treated by autologous injection of platelet rich plasma. Materials and Methods: This was a prospective cohort study conducted in department of orthopedics of a tertiary care medical college located in an urban area. The patients diagnosed to be having plantar fasciitis were included in this study on the basis of a predefined inclusion and exclusion criteria. Patients were assessed for severity of pain by the Visual Analogue Score for pain and American orthopedic foot and ankle score (AOFAS). A VAS score of 0-3 was taken as pain relief and VAS score of 4-10 was considered as no pain relief. Whereas AOFAS scores of 90-100, 80-89, 60-79 and less than 60 were taken as excellent, good, fair and poor outcome respectively. All patients were treated by local injection of autologous platelet rich plasma. The patients were followed up at 4 weeks, 8 weeks and 12 weeks. During follow up visits the pain relief was assessed by VAS and AOFAS scores. For statistical purposed SSPS 21.0 software was used and p value less than 0.05 was taken as statistically significant. Results: A total of 60 patients were included in this study out of which there were 22 (36.67%) males and 38 (63.33%) females with a M:F ratio of 1:1.72. The most common affected age group was between the age of 41-50 years (35%) followed by 51-60 years (21.67%) and 31-40 years (20%). Twenty-seven (45%) patients were either overweight or obese. A statistically significant reduction in pain was documented at the time of follow up of 4 weeks. At the end of 12 weeks 58 (96.67%) patients experienced significant pain relief and only 2 (3.33%) patients had significant pain. Also, there was statistically significant difference between AOFAS scores at the time of presentation and at 4 weeks, 8 weeks and 12 weeks follow up visits. Conclusion: Injection of autologous platelet rich plasma for chronic plantar fasciitis is found to have promising results in terms of pain relief (reduced VAS score) and functional outcome (Improvement in AOFAS score).

scholarly journals Autologous platelet rich plasma versus corticosteroid injection for chronic plantar fasciitis: a prospective controlled randomized comparative clinical study

2018 ◽  
Vol 6 (5) ◽  
pp. 1594 ◽  
Author(s):  
Sachin Upadhyay ◽  
Vijendra Damor
Keyword(s):  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Primary Objective ◽  
Control Group ◽  
Base Line ◽  
Autologous Platelet Rich Plasma ◽  
American Orthopaedic ◽  
Autologous Platelet

Background: Primary objective was to evaluate and compare the effectiveness of autologous platelet rich plasma (PRP) and steroid injections in chronic cases of plantar fasciitis.Methods: The present study was a prospective cohort study; 140 consecutive patients with chronic plantar fasciitis were enrolled and randomized in two groups: One receives the Platelet rich plasma (PRP) therapy (study group) and another receiving corticosteroid injection (control group). The outcomes in both groups are then evaluate and compared using visual analogue scale (VAS) and American Orthopaedic foot and Ankle Society (AOFAS) scale at 1month, 3month and 6 month post injection. The level of significance was set at p <0.05.Results: Prospective data was collected of 140 heels. The average follow up duration was about 6 months. The score on VAS scale and AOFAS improved from base line for both group but the patients received PRP therapy had a statistically significant (p<0.05) reduction in pain and improved AOFAS score at last follow up. No adverse complications were reported.Conclusions: The result of present study showed that the PRP therapy has potential to reduce pain and improve the functional outcome in cases of chronic planter fasciitis. It was found to be more effective and significantly better than corticosteroid injection.

scholarly journals Efficacy of intralesional corticosteroid versus autologous platelet rich plasma injection in the management of chronic plantar fasciitis

2018 ◽  
Vol 4 (5) ◽  
pp. 790
Author(s):  
Divya Anil Kumar ◽  
Harsha Kumar Koramutla
Keyword(s):  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Vas Score ◽  
Plasma Injection ◽  
Intralesional Corticosteroid ◽  
Group A ◽  
Autologous Platelet Rich Plasma ◽  
Group B ◽  
Autologous Platelet

<p class="abstract"><strong>Background:</strong> Plantar fasciitis is a common pathological condition affecting the hind foot, and a common cause of heel pain. The present study was taken up to assess the efficacy of intralesional corticosteroid compared to autologous platelet rich plasma injection in the management of chronic plantar fasciitis.</p><p class="abstract"><strong>Methods:</strong> Patients were randomized into two groups (Group A and Group B) of 30 each. Group-A received Corticosteroid injection while Group-B received PRP injection. Patients were assessed functionally using American Orthopaedic Foot and ankle score (AOFAS), Visual analogue scale (VAS) scores before treatment and on follow-up visit at 6 weeks, 3rd month, and 6th month. Ultrasound of heel for plantar fascia thickness was measured before treatment and follow up visit at 6th month.<strong></strong></p><p class="abstract"><strong>Results:</strong> A significant decrease in VAS score was observed in the corticosteroid group compared to PRP group at 6 weeks while the VAS score continued to decrease in the PRP group at 3 months and 6 months with an increase in the corticosteroid group at 3 months and 6 months. A significant increase in AOFAS was observed in the Corticosteroid group compared to PRP group at 6 weeks which increased in the PRP group at 3 months and 6 months. However it decreased in the corticosteroid group at 3 months and 6 months. Ultrasonographic evaluation showed improvement in fascial thickness in both the groups, but was better in the PRP group.</p><p class="abstract"><strong>Conclusions:</strong> To conclude our study shows that corticosteroid is more effective for short term relief and PRP is more effective for long term relief.</p>

scholarly journals Treatment of symptomatic degenerative intervertebral discs with autologous platelet-rich plasma: follow-up at 5–9 years

2019 ◽  
Vol 14 (9) ◽  
pp. 831-840 ◽  
Author(s):  
Jennifer Cheng ◽  
Kristen A Santiago ◽  
Joseph T Nguyen ◽  
Jennifer L Solomon ◽  
Gregory E Lutz
Keyword(s):  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Intervertebral Discs ◽  
Discogenic Pain ◽  
Autologous Platelet Rich Plasma ◽  
Clinically Significant ◽  
And Function ◽  
Pain Patients ◽  
Autologous Platelet

Aim: This study assessed pain and function at 5–9 years postinjection in a subset of patients who received intradiscal platelet-rich plasma (PRP) injections for moderate-to-severe lumbar discogenic pain. Patients & methods: All patients received injections of intradiscal PRP in a previous randomized controlled trial. Data on pain, function, satisfaction, and need for surgery were collected at one time point of 5–9 years postinjection and compiled with existing data. Results: In comparison to baseline, there were statistically significant improvements in pain and function (p < 0.001). All improvements were clinically significant. Six patients had undergone surgery during the follow-up period. Conclusion: This subset of patients demonstrated statistically and clinically significant improvements in pain and function at 5–9 years postinjection.

scholarly journals A 5-Year Follow-Up After Cartilage Repair in the Knee Using a Platelet-Rich Plasma-Immersed Polymer-Based Implant

2014 ◽  
Vol 8 (1) ◽  
pp. 346-354 ◽  
Author(s):  
Alberto Siclari ◽  
Gennaro Mascaro ◽  
Christian Kaps ◽  
Eugenio Boux
Keyword(s):  
Clinical Outcome ◽  
Cartilage Repair ◽  
Platelet Rich Plasma ◽  
Polyglycolic Acid ◽  
Cartilage Defects ◽  
Bone Marrow Stimulation ◽  
Chondral Defects ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

The aim of our study was to analyze the clinical outcome after repair of cartilage defects of the knee with subchondral drilling and resorbable polymer-based implants immersed with autologous platelet-rich plasma (PRP). Fifty-two patients with focal chondral defects were treated with subchondral drilling, followed by covering with a polyglycolic acid - hyaluronan (PGA-HA) implant (chondrotissue®) immersed with autologous PRP. At 5-year follow-up, patients’ situation was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and compared to the pre-operative situation. The KOOS showed clinically meaningful and significant (p < 0.05) improvement in all subcategories compared to baseline. Subgroup analysis showed that there were no differences in the clinical outcome regarding defect size and localization as well as degenerative condition of the knee. Cartilage repair was complete in 20 out of 21 patients at 4-year follow-up as shown by magnetic resonance observation of cartilage repair tissue (MOCART) scoring. Covering of focal cartilage defects with the PGA-HA implant and PRP after bone marrow stimulation leads to a lasting improvement of the patients’ situation.

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