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International Orthopaedics

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01-06-2017 | Original Paper

A systematic review and meta-analysis of platelet-rich plasma versus corticosteroid injections for plantar fasciopathy

Authors: Prashant Singh, Suroosh Madanipour, Jagmeet S. Bhamra, Ian Gill

Published in: International Orthopaedics | Issue 6/2017

Abstract

Purpose

To determine whether platelet-rich plasma (PRP) injections are associated with improved pain and function scores when compared with corticosteroid injections for plantar fasciopathy.

Methods

A systematic review of published literature was performed for studies comparing PRP injections and corticosteroid injections for plantar fasciopathy. Studies were assessed using the Cochrane Risk of Bias Tool and the Newcastle Ottawa Scale (NOS). The primary endpoint was pain and function score at three and six month follow-up. Sensitivity analysis was performed for high quality studies and randomised studies.

Results

Ten studies totalling 517 patients were included. Seven studies were randomised. All studies included patients who had failed conservative measures and excluded patients with systemic illness and other causes of foot pain. Studies reported outcomes using the visual analogue score (VAS) and American Orthopaedic Foot and Ankle Score (AOFAS). At 3-month follow-up, PRP injections were associated with improved VAS scores (standard mean difference [SMD], -0.66; 95% CI, -1.3 to -0.02; p = 0.04) and AOFAS scores (SMD, 1.87; 95% CI, 0.16–3.58; p = 0.03). At 6-month follow-up, there was no difference in VAS score (SMD, -0.66; 95% CI, -1.65 to 0.3; p = 0.17) or AOFAS scores (SMD, 1.69; 95% CI, -1.06 to 4.45; p = 0.23). No studies reported adverse event rates or cost analysis. There was no difference in pain or function score at one, six- or 12-month follow-up. Sensitivity analyses of high-quality studies showed no differences between the PRP and steroid group at any of the follow-up points.

Conclusions

PRP injections are associated with improved pain and function scores at three month follow-up when compared with corticosteroid injections. Information regarding relative adverse event rates and cost implications is lacking. Further, large-scale, high-quality, randomised controlled trials with blinding of outcome assessment and longer follow-up are required.

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Title: A systematic review and meta-analysis of platelet-rich plasma versus corticosteroid injections for plantar fasciopathy
Authors: Prashant Singh
Suroosh Madanipour
Jagmeet S. Bhamra
Ian Gill
Publication date: 01-06-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 6/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3470-x

At a glance: The STEP trials

Springer Medicine

A systematic review and meta-analysis of platelet-rich plasma versus corticosteroid injections for plantar fasciopathy

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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