International Journal of Research in Orthopaedics | May-June 2018 | Vol 4 | Issue 3 Page 371 International Journal of Research in Orthopaedics Thora A et al. Int J Res Orthop. 2018 May;4(3):371-375 http://www.ijoro.org Original Research Article Efficacy of platelet rich plasma in comparison to steroid for the management of chronic plantar fasciitis Ankit Thora 1 *, Anurag Tiwari 2 , Nishit Bhatnagar 3 , Mukul Mohindra 4 INTRODUCTION Plantar fasciitis is one of the most common diagnoses in patients presenting with chronic foot pain that upsets roughly 10% of the population. 1 Owing to its failure to respond easily to conservative and interventional modalities it produces extensive annual economic burden. The pathophysiology is still not extensively understood, but is known to involve microscopic degeneration of the plantar fascia and local disruption of the collagen matrix and microtears rather than an inflammatory pathology. 2 Predisposing factors include stress produced by excessive weight-bearing activity, obesity, stiff ankle, and walking or running on uneven and hard surfaces. The presence of zones of hypovascularization and hypervascularization in the fascia has also been hypothesized. 3,4 Clinically pain, local tenderness and associated morning heel stiffness which improves as the patient carries out daily activities are hallmark of this disorder. 5 A battery of conservative and interventional approaches have been postulated and are prevalent on personal experiences but no consensus is available in terms of reproducible results. Non-operative approaches include rest, contrast bath, sole inserts, stretching and ABSTRACT Background: Chronic plantar fasciitis is often a difficult to treat entity and platelet-rich plasma (PRP) is an upcoming modality instead of steroid in chronic cases of plantar fasciitis resistant to traditional non-operative management. Methods: Sixty patients with chronic plantar fasciitis were prospectively randomised into 2 groups and treated with either a single injection of 3 cc PRP or 40 mg DepoMedrol (Cortisone) injection and followed for a year. Immediately prior to PRP or cortisone injection American Orthopedic Foot and Ankle Society (AOFAS) hind foot scoring was done for all patients. These scores were repeated at 6 weeks, 6 months and 12 months. Results: Six weeks evaluation of AOFAS after PRP and corticosteroid administration, the mean visual analogue scale (VAS Score) showed a significant increase in corticosteroid group (4.2) as compared to PRP group (5.8). But, the PRP group (1.8) showed significant improvement in mean VAS scores as compared to Steroid group (3.4) after a year of the treatment. Similarly, the AOFAS score improved significantly in the steroid group (64.4) at 6wks as compared to the PRP group (52.2) but at 12 months however, the PRP group sustained its effect with a mean AOFAS score of 92.2 while in the steroid group, the score dropped to a mean of 78.4. Conclusions: PRP was more effective than steroid for the long term treatment of chronic plantar fasciitis. Level of Evidence: Level I, prospective randomized comparative series. Keywords: PRP, Steroid injection, Plantar fasciitis Department of Orthopaedics, 1 Shalby Hospital, Indore, 2 AIIMS Hospital, Bhopal, Madhya Pradesh, 3 Maulana Azad Medical College, New Delhi, 4 Safdarjung Hospital, Delhi, India Received: 26 March 2018 Revised: 12 April 2018 Accepted: 13 April 2018 *Correspondence: Dr. Ankit Thora, E-mail: dr.ankit20@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20181671