LOCAL CORTICOSTEROID VS. AUTOLOGOUS BLOOD FOR PLANTAR FASCIITIS
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 1
Abstract
BACKGROUND Plantar fasciitis is the most common cause of heel pain for which professional care is sought. Initially thought of as an inflammatory process, plantar fasciitis is a disorder of degenerative changes in the fascia and maybe more accurately termed plantar fasciosis. Traditional therapeutic efforts have been directed at decreasing the presumed inflammation. These treatments include icing, Nonsteroidal Anti-inflammatory Drugs (NSAIDs), rest and activity modification, corticosteroids, botulinum toxin type A, splinting, shoe modifications and orthosis. Other treatment techniques have been directed at resolving the degeneration caused by the disease process. In general, these techniques are designed to create an acute inflammatory reaction with the goal of restarting the healing process. These techniques include autologous blood injection, Platelet-Rich Plasma (PRP) injection, nitroglycerin patches, Extracorporeal Shock Wave Therapy (ESWT) and surgical procedures. Recently, research has focused on regenerative therapies with high expectations of success. The use of autologous growth factors is thought to heal through collagen regeneration and the stimulation of a well-ordered angiogenesis. These growth factors are administered in the form of autologous whole blood or Platelet-Rich Plasma (PRP). Platelets can be isolated using simple cell-separating systems. The degranulation of the alpha granules in the platelets releases many different growth factors that play a role in tissue regeneration processes. Platelet-derived growth factor, transforming growth factor-P, vascular-derived endothelial growth factor, epithelial growth factor, hepatocyte growth factor and insulin-like growth factor are examples of such growth factors. Injections with autologous growth factors are becoming common in clinical practice. The present study was an attempt to compare the efficacy of autologous blood injection in plantar fasciitis by comparing it with the local corticosteroid injection. MATERIALS AND METHODS A total of 120 patients who attended Orthopaedic OPD at Government General Hospital, Kakinada, during the time spanning January 2015 to December 2015, who were suffering from plantar fasciitis were randomly allocated either autologous blood injection or corticosteroid injection as treatment. Both groups were analysed with VAS and Nirschl pain staging at presentation, 1 st week, 4th week, 12th week and at six-month intervals. Results were tabulated and analysed statistically. All patients were treated on OPD basis. No inpatient care was needed in any patient. RESULTS In this study, slight male preponderance was seen in both the groups (53.33%). The mean in group A was 41.80±10.96 years and in group B the mean age was 40.68±10.47 years. Most of the patients in group A and B presented with right foot involvement (51.67% and 65.00%). The mean duration in group A was 10.88 weeks compared to 8.62 weeks in group B. The mean VAS scores at the beginning were comparable in both the groups (7.55±1.40 vs. 7.70±1.14). At fourth week, the mean VAS score in group A significantly reduced to 3.18±2.38 and at 12 weeks and six months to 0.3±1.37 suggesting significantly less pain in group A compared to group B. Similar trend of reduction among patients is group A was observed with Nirschl staging scores. No patient in group A reported complications and recurrence was not observed in patients with group A. CONCLUSION Based on the results of our present study, it maybe concluded that autologous blood injection significantly reduced the pain based on VAS and Nirschl staging without complications there by lowering the recurrence rate up to six months in patients with plantar fasciitis. It also provided complete relief of pain for the period of six months without any complication. Autologous blood is simple to acquire and prepare, easy to carry out. Hence, autologous blood provides intermediate and long-term results in term of pain relief when compared to corticosteroid injection, which gives early and short-term relief of pain from plantar fasciitis.
Authors and Affiliations
Mani Kumar C. J, Syam Sunder B, Praveen Sivakumar K
Keywords
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- EP ID EP210951
- DOI 10.18410/jebmh/2017/2
- Views 146
- Downloads 0
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