Outcomes of platelet-rich plasma for plantar fasciopathy: a best-evidence synthesis
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(2020) 15:432
SYSTEMATIC REVIEW
Open Access
Outcomes of platelet-rich plasma for plantar fasciopathy: a best-evidence synthesis Tao Yu†, Jiang Xia†, Bing Li*, Haichao Zhou, Yunfeng Yang* and Guangrong Yu
Abstract Background: Plantar fasciopathy (PF) is a very common disease, affecting about 1/10 people in their lifetime. Platelet-rich plasma (PRP) had been demonstrated to be useful in achieving helpful effects for plantar fasciopathy. The purpose of this study was to compare the pain and functional outcomes between PRP and corticosteroid (CS) or placebo for plantar fasciopathy through meta-analysis and provide the best evidence. Methods: Literature was searched systematically to explore related studies that were published in Cochrane Library, PubMed, Embase, Medline, SpringerLink, OVID, and ClinicalTrials.gov. Articles regarding comparative research about the outcomes of PRP therapy and CS or placebo injection were selected. Data of pain and functional outcomes was extracted and imported into Reviewer Manager 5.3 to analyze. Results: Thirteen RCTs were included and analyzed. Analysis results showed significant superiority of PRP in outcome scores when compared with CS (VAS: MD = − 0.85, P < 0.0001, I2 = 85%; AOFAS: MD = 10.05, P < 0.0001, I2 = 85%), whereas there is no statistical difference in well-designed double-blind trials (VAS: MD = 0.15, P = 0.72, I2 = 1%; AOFAS: MD = 2.71, P = 0.17, I2 = 0%). In the comparison of the PRP and the placebo, the pooled mean difference was − 3.76 (P < 0.0001, 95% CI = − 4.34 to − 3.18). Conclusions: No superiority of PRP had been found in well-designed double-blind studies, whereas it is implied that the outcomes of PRP are better than placebo based on available evidence. Keywords: Platelet-rich plasma, Corticosteroid, Fasciopathy, Therapy
Background Plantar fasciitis (PF) is a very common disease, affecting about 1/10 people in their lifetime and subsequently affected the quality of life [1]. A variety of treatments had been carried out for plantar fasciopathy, including orthoses [2, 3], shockwave therapy [4, 5], drug medication [6], stretching exercise [7, 8], laser therapy [9], taping [10], and percutaneous injection [11]. But PF is difficult to cure completely. * Correspondence: [email protected]; [email protected] † Tao Yu and Jiang Xia contributed equally to this work. Department of Orthopedic Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
Platelet-rich plasma (PRP) is most concisely defined as a volume of plasma that contains a concentrate of platelets above that of baseline blood levels [12]. In recent years, the role of PRP in the treatment of PF has drawn wide attention [13–19]. However, the advantages of PRP in modern treatment for PF have not been fully confirmed, and different randomized controlled trials have drawn inconsistent conclusions when comparing the use of PRP with CS or placebo [20, 21]. The method of injecting corticosteroids (CS) is another common treatment that has proven to be effective [22, 23], but it
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