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Category: Volume 05 Issue 08 August 2017
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Title: Comparative Study of 30 Cases of Local Injection of Autologous Blood and Corticosteroids in Treatment of Plantar Fascitis

Authors: Bhupinder Singh Brar, Satbir Singh, Amandeep Singh Bakshi, Daljinder Singh, Ashish Garg, Karan Alawadhi

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.96

Abstract

Introduction: Plantar fascitis is a painful heel condition associated with Obesity, Poor foot alignment, Prolonged Standing, Fat pad atrophy causing significant distress in day to day activities. The objective of the current study was to evaluate and compare the treatment outcomes and complications of local injection of steroid derivatives and autologus blood in the management of plantar fasciitis.

Material and Methods: This randomized, interventional study was conducted on OPD basis on 60 patients suffering from plantar fasciitis. Patients were divided into two groups, Total 30 patients in each group (group-I steroid group, group-II autologous blood group). Point of maximum tenderness at anteromedial tuberosity of calcaneum was identified and injected under asceptic precautions using peppering technique.

Results: Patients were followed up at regular intervals (2 weeks,6 weeks,3 months and 6 months) for pain severity (VAS score),Functional outcome(RM score), any complications, recurrence of symptoms, requirement of analgesics and physiotherapy. Results were analysed statistically using chi-square test and student’s t-test .

Conclusion: Autologous Blood Injection significantly reduces the pain without any complications. Autologous blood is easyto acquire and prepare,  provides intermediate and long term results in term of pain relief in comparison to corticosteroid injection which gives short term relief with comparatively high recurrence rate. Autologous blood is easy to procure and administer than PRP also (Platelet Rich Plasma procurement requires much more cost and patient compliance). Thus, highly useful for economically under developed and developing countries.

Keywords: Plantar fasciitis, Autologous blood injection, Corticosteroid injection.

References

  1. Murphy GA. Disorders of Tendons and Fascia and adolescent and adult pes planus. In Campbell's Operative Orthopaedics, Canale ST, Beaty JH eds., 12th Elsevier 2013;82:3954.
  2. Young CC, Rutherford DS, Niedfeldt MW. Treatment of plantar fasciitis. Am Fam Physician. 2001;63(3):467-74,477-8.
  3. Khan KM, Cook JL, Taunton JE, Bonar F. Overuse tendinosis, not tendinitis: a new paradigm for a difficult clinical problem (part 1).Phys Sportsmed. 2000;28:38–48.
  4. Moseley JB Jr, Chimenti BT. Foot and ankle injuries in theprofessional athlete. In: Baxter DE, ed. The Foot and Ankle in Sport. St. Louis, Mo: Mosby-Year Book; 1995:321-8.
  5. Tong KB, Furia J. Economic burden of plantar fasciitis treatment in the United States. Am J Orthop (Belle Mead NJ) 2010;39(5):227-31.
  6. McPoil TG, Martin RL, Cornwall MW, Wukich DK, Irrgang JJ, Godges JJ. Heel pain-plantar fasciitis: clinical practice guildelines linked to the international classification of function, disability, and health from the orthopaedic section of the American Physical Therapy Association.J Orthop Sports Phys Ther. 2008;38:A1–18. 
  7. Tahririan MA1, Motififard M, Tahmasebi MN, Siavashi B. Plantar fasciitis. J Res Med Sci. 2012;17(8):799-804.
  8. Andia I, Sanchez M, Maffulli N. Tendon healing and platelet-rich plasma therapies.Expert Opin BiolT her. 2010; 8(10):1415–1426.
  9. Lee TG, Ahmad TS. Intralesional autologous blood injection compared to corticosteroid injection for treatment of chronic plantar fasciitis. A prospective, randomized, controlled trial. Foot Ankle Int. 2007;28(9):984-90.
  10. Kalaci A, Cakici H, Hapa O et al. (2009) Treatment of plantar fasciitis using four different local injection modalities: a randomized prospective clinical trial. Journal of the American Podiatric Medical Association 99: 108–13
  11. Gupta M, Latkar C. Efficacy and Role of Local Injection of Platelet Rich Plasma and Local Corticosteroid Injection in the Treatment of Plantar Fasciitis: Indian journal of applied research:Volume : 5 | Issue : 2 | Feb 2015 | ISSN - 2249-555X.
  12. Modi V J,Patel M Z et al.Autologous blood injections: a less fancy but more cost-effective method to treat plantar fascitis: International Journal of Current Pharmaceutical & Clinical Research : Vol 5 | Issue 3 | 2015 | 153-156.
  13. Abdihakin M, Wafula K, Hasan S and MacLeod J: A randomised controlled trial of steroid injection in the management of plantar fasciitis. SA Orthop J 11: 33‑38, 2012.
  14. DiGiovanni BF, Nawoczenski DA, Lintal ME, Moore EA, Murray JC, Wilding GE, et al. Tissue-specific plantar fascia stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study.J Bone Joint Surg Am. 2003;85-A:1270–7. 
  15. ShoaibM,Askar Z.Effectiveness of autologous blood injections in patients with plantar fasciitis: J. Med. Sci. (Peshawar, Print) October 2012, Vol. 20, No. 4: 155-158.
  16. Ball EM, McKeeman HM, Patterson C, et al: Steroid injection for inferior heel pain: A randomised controlled trial. Ann Rheum Dis 72: 996‑1002, 2013.
  17. Kiter E, Celikbas E, Akkaya S et al. (2006) Comparison of injection modalities in the treatment of plantar heel pain: a randomized controlled trial. Journal of the American Podiatric Medical Association 96: 293–6.
  18. Barrett SL, Erredge SE (2004) Growth factors for chronic plantar fasciitis. Podiatry Today 17: 36–42.
  19. Molloy LA: Managing chronic plantar fasciitis: when conser­vative strategies fail. JAAPA 25: 52‑53, 2012.
  20. Gidumal R and Evanski P: Calcaneal osteomyelitis following steroid injection: a case report. Foot Ankle 6: 44‑46, 1985.
  21. Buccilli Ta Jr, Hall HR and Solmen JD: Sterile abscess formation following a corticosteroid injection for the treatment of plantar fasciitis. J Foot Ankle Surg 44: 466‑468, 2005.

Corresponding Author

Satbir Singh

Department of Orthopaedics,

Government Medical College, Patiala, Punjab, India 147001