Background
Plantar fasciitis (PF) is the most common cause of heel pain. Some patients with PF are resistant to conservative lines of management, which can lead to physical disability. The aim of this study is to compare the effectiveness and outcome of endoscopic plantar fasciotomy (EPF) and local injection of platelet-rich plasma (PRP) for treatment of resistant cases of PF.
Patients and methods
A total of 51 patients with resistant PF were enrolled in this study between August 2011 and May 2014. Patients were either enrolled in the surgical (EPF) group (25 patients) or to the PRP group (26 patients) after a minimum period of conservative treatment of 6 months. Before and after visual analog scores (VAS) and American orthopaedic foot and ankle society (AFOAS) were recorded and compared between the two groups.
Results
Both groups achieved improvement at 6 weeks, 6 months, and 12 months. At the end of follow-up, in the first group (EPF), the average VAS was improved from 8.31 to 2.34, and the average AFOAS was improved from 43.75 to 87.25. A total of 20 (80%) patients were satisfied, four (16%) patients were satisfied with reservation, and one (4%) patient was not satisfied. In the second group (PRP), the average VAS was improved from 8.28 to 2.55, and the average AFOAS was improved from 42.95 to 86.75. A total of 19 (73.08%) patients were satisfied, five (19.23%) patients were satisfied with reservation, and two (7.69%) patients were not satisfied.
Conclusion
Both EPF and PRP are effective in treating resistant PF, and the end results of EPF are better than those of PRP injection regarding pain relief, AFOAS, and patient satisfaction. So PRP injection should be tried before invasive surgical interference.