The Heel Complex: Anatomy, Imaging, Pathologic Conditions, and Treatment.

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Abstract

[Indexed for MEDLINE] 19. Foot Ankle Surg. 2024 Jun;30(4):285-293. doi: 10.1016/j.fas.2024.02.004. Epub 2024 Feb 15. Platelet rich plasma therapy versus other modalities for treatment of plantar fasciitis: A systematic review and meta-analysis. Herber A(1), Covarrubias O(2), Daher M(2), Tung WS(3), Gianakos AL(3). Author information: (1)Department of Surgery, University of Arizona College of Medicine - Phoenix, Phoenix, AZ 85004, USA. Electronic address: agustin.herber@midwestern.edu. (2)Department of Orthopedics, Brown University, Providence, RI 02906, USA. (3)Department of Orthopaedics and Rehabilitation, Yale University, New Haven, CT 06510, USA. INTRODUCTION: Plantar fasciitis (PF) is the most common cause of heel pain in adults. There are numerous non-operative treatments available including platelet rich plasma (PRP) injections. PPR has demonstrated effectiveness for a range of musculoskeletal conditions including plantar fasciitis. PURPOSE/OBJECTIVE: To compare the effectiveness of PRP to other conservative treatment options for the management of PF. METHODS: A systematic search of PubMed and Google Scholar was performed for randomized control trials (RCT) comparing PRP to other treatment modalities. Studies met inclusion criteria if mean and standard deviations for visual analog scale (VAS) pain scores, plantar fascia thickness (PFT), Foot Function Index (FFI), or American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score were reported. Mean differences (MD) were used to compare VAS pain, PFT, FFI, and AOFAS between PRP and other treatments. RESULTS: Twenty-one RCTs which altogether included 1356 patients were included in the meta-analysis. PRP demonstrated significantly greater improvements in VAS pain scores compared to extracorporeal shock wave therapy (ESWT) (SMD: 0.86; CI: [0.30, 1.41]; p = 0.002), corticosteroid injections (CSI) (SMD: 1.08; CI: [0.05, 2.11]; p = 0.04), and placebo (SMD: 3.42; CI: [2.53, 4.31]; p