PRP (Platelets Rich Plasma) for Plantar Fasciitis – Does it work?

Introduction: Plantar fasciitis (PF) is the most prevalent cause of heel pain. Among those affected up to 5-10% endure symptoms lasting longer than 6 to 12 months, necessitating more aggressive treatment strategies. Platelet-rich plasma (PRP) is an autologous blood-derived product that has demonstrated promising results in recent years for various musculoskeletal conditions, including PF. However, data regarding the efficacy of PRP in treating PF remains limited. This study aims to present a single surgeon’s experience with PRP in the management of recalcitrant PF. Methods: This investigation is a case series conducted by a single surgeon, involving 50 feet from 48 patients diagnosed with PF between January 2022 and December 2023, all of whom received PRP treatment. The study involved a retrospective review of prospectively collected data as part of standard clinical care and was classified as a service evaluation by the local ethics committee. All patients had undergone at least three months of conservative treatment prior to receiving PRP. Data collected included age, co-morbidities, body mass index (BMI), plantar fascia thickness prior to PRP treatment, and visual analogue scale (VAS) scores before and after PRP treatment. Additionally, the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scores were recorded before and after treatment. Complications following PRP injections and the number of patients requiring surgical intervention for PF during the study period were also documented. Results: The study comprised 50 feet in 48 patients, with an average age of 48.3 years (range: 31-76) and an average BMI of 27.3 (range: 22-39). The average plantar fascia thickness prior to PRP treatment was 6.3 mm (range: 4.3-7 mm). The average VAS score before PRP treatment was 7.6 (range: 6-9), which improved to 2.3 (range: 1-4, P < 0.05) at the six-month follow-up. AOFAS hindfoot scores also demonstrated improvement following PRP treatment. The average AOFAS score prior to treatment was 45.3 (range: 29-69), increasing to 71.7 (range: 55-91, P = 0.052) at three months post-treatment, and further improving to 89.3 (range: 79-97, P < 0.05) at six months. Notably, 83% of patients returned to their sporting activities without limitations by six months post-treatment. Only 6% of patients required surgical intervention for persistent symptoms within the six-month follow-up period, and no complications were reported during the study. Conclusion: This study demonstrates that PRP infiltration for recalcitrant plantar fasciitis is both safe and effective. The treatment resulted in significant improvements in functional, clinical, and pain outcome scores. Only 6% of patients in this study progressed to surgical intervention within the study period.