Khabeer Ahmad Khattak, Basit Hussain, Muhammad Imran Javed, Javedullah Khan, Nadeem-ur Rehman, Imtiaz Ahmad.
Determination of the effectiveness of platelets rich plasma injection in treatment of plantar fasciitis.
Pak J Surg Jan ;36(4):310-4.

Introduction: Plantar fasciitis is one of the commonest, and most frustrating, foot ailments seen in a regular Orthopedic clinic. Plantar fascia is a connective tissue on the posterior surface of the foot which connects heel bone to toes. It helps in maintaining the medial arch of the foot and functions as shock absorber during walking mechanism. Plantar fasciitis (PF) is a degenerative tissue condition which involves plantar fascia at the site of its origin at the medial tuberosity of the calcaneous and causes heal pain. Plantar fasciitis affects sport participants as well as physically inactive middle-aged individuals; however, age, obesity, excessive weight bearing, and tight Achilles tendon are the common predisposing factors. The peak incidence occurs between 40 and 60 years of age in both genders. Plantar fasciitis is usually diagnosed on the basis of history and clinical findings. Generally, patients with plantar fasciitis feel worsening heal pain when they first step on the floor in the early morning. However, as the patient starts physical activity the pain gradually improves. Dorsiflexion of the toes deteriorates the pain as this action causes pulling of the plantar fascia. Objective: To determine the effectiveness of platelets rich plasma injection in treatment of plantar fasciitis. Setting: Department of Orthopedic and Trauma, Khyber Teaching Hospital, Peshawar & District Headquarter Hospital (DHQ), KDA, Kohat. Study design: Descriptive case series. Duration of study: 14 April, 2018 to 14 October, 2018. Material and Methods: All patients with planter fasciitis, who presented to outpatient department at Orthopedic and Trauma units were included in the study based upon the selection criteria. An informed consent was taken. For each patient, demographic information (age, sex and address) was recorded. For each patient 55 milliliters whole blood was collected from the un-involved arm into a 60 ml syringe that contained 5 ml sodium citrate. The blood was centrifuged to obtain approximately 3 ml platelet concentrate for each patient and injected in the foot affected with plantar fasciitis. Prior to the procedure the patients was assessed using numerical rating scale (NRS) for grading of plantar fasciitis pain. Results: As per efficacy of platelet rich plasma (PRP), on 144 (89.44%) patients it was effective whereas on 17 (10.55%) patients platelet rich plasma was not proved effective. Conclusion: In this study we concluded that PRP therapy might provide an effective alternative to conservative management of PF with no obvious side effect or complication. The onset of action aft er PRP injection also greatly depended on the degree of degeneration.

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