Abstract:Objective To investigate the clinical efficacy of radial extracorporeal shockwave therapy(ESWT)combined with platelet-rich plasma(PRP)injection in the treatment of chronic plantar fasciitis.Methods In this prospective,single-center,randomized control trial,60 patients with chronic plantar fasciitis treated in our hospital from January 2017 to Dec. 2018 were randomly divided into ESWT group,PRP group and ESWT-PRP combined group,with 20 cases in each group.The visual analogue scale (VAS) and revised foot function index (FFI-R) was compared before treatment,and 4,12 and 24 weeks after treatment.We calculated the thickness of the plantar fascia under the ultrasound localization before treatment and 24 weeks after treatment.Results There were no significant differences of the characteristics,VAS scores or FFI-R scores between 3 groups.After treatment,the VAS scores and FFI-R scores of 3 groups were significantly improved than before treatment (P<0.05).The improvement of VAS and FFI-R scores in the ESWT group and ESWT-PRP combined group were superior to the PRP group in the 4th week (P<0.05),while the improvement of VAS and FFI-R scores in the PRP group and ESWT-PRP combined group were superior to the ESWT group in the 24th week (P<0.05).There was significant improvement in the thickness of the plantar fascia before treatment and 24 weeks after treatment in all groups (P< 0.05).VAS score was positively correlated with the thickness of the plantar fascia.No serious adverse reactions occurred after the treatment.Conclusion Radial extracorporeal shockwave therapy combined with platelet-rich plasma injection is a safe and effective treatment for chronic plantar fasciitis,and it has rapid onset,lasting results and no adverse effect.It’sworthy further clinical research and promotion.
[1]张晓倓,张立宁,肖红雨.冲击波治疗足底筋膜炎的临床研究进展[J].解放军医学院学报,2015,36(6):631-633.
[2]Yinilmez Sanmak ÖD,Geler Külcü D,Mesci N,et al.Comparison of effects of low-level laser therapy and extracorporeal shock wave therapy in plantar fasciitis treatment:A randomized,prospective,single-blind clinical study[J].Turk J Phys Med Rehabil,2018,65(2):184-190.
[3]Franceschi F,Papalia R,Franceschetti E,et al.Plateletrich plasma injections for chronic plantar fasciopathy:a systematic review[J].Br Med Bull,2014,112(1):83-95.
[4]Kim C,Cashdollar MR,Mendicino RW,et al.Incidence of plantar fascia ruptures following corticosteroid injection[J].Foot Ankle Spec,2010,3(6):335-337.
[5]周迪远,陶惠红,杨耀琴,等.体外冲击波对肌肉骨骼痛症的抗炎镇痛机制[J].实用骨科杂志,2017,23(7):618-625.
[6]Xiong Y,Wu Q,Mi B,et al.Comparison of efficacy of shockwave therapy versus corticosteroids in plantar fasciitis:a meta-analysis of randomized controlled trials[J].Arch Orthop Trauma Surg,2019,139(4):529-536.
[7]Vannini F,Di Matteo B,Filardo G,et al.Platelet-rich plasma for foot and ankle pathologies:a systematic review[J].Foot Ankle Surg,2014,20(1):2-9.
[8]颜世昌,王鑫强,成婷婷,等.发散式体外冲击波与传统方式治疗跖筋膜炎的效果比较[J].中国医药导报,2018,15(27):66-69.
[9]魏芳远,曲峰,王显军,等.富含血小板血浆治疗慢性跖筋膜炎疗效分析[J].中国医学前沿杂志,2019,11(5):43-46.
[10]Budiman-Mak E,Conrad K,Stuck R,et al.Theoretical model and Rasch analysis to develop a revised Foot Function Index[J].Foot Ankle Int,2006,27(7):519-527.
[11]Li S,Wang K,Sun H,et al.Clinical effects of extracorporeal shock-wave therapy and ultrasound-guided local corticosteroid injections for plantar fasciitis in adults:A metaanalysis of randomized controlled trials[J].Medicine,2018,97(50):e13687.
[12]Sun K,Zhou H,Jiang W.Extracorporeal shock wave therapy versus other therapeutic methods for chronic plantar fasciitis[J].Foot Ankle Surg,2020,26(1):33-38.
[13]Mishra BN,Poudel RR,Banskota B,et al.Effectiveness of extracorporeal shock wave therapy(ESWT)vs methylprednisolone injections in plantar fasciitis[J].J Clin Orthop Trauma,2019,10(2):401-405.
[14]Çaglar Okur S,Aydin A.Comparison of extracorporeal shock wave therapy with custom foot orthotics in plantar fasciitis treatment:A prospective randomized one-year follow-up study[J].J Musculoskelet Neuronal Interact,2019,19(2):178-186.
[15]李剑峰,刘福云.两种冲击波方法治疗慢性跖筋膜炎疗效的比较[J].中国矫形外科杂志,2018,26(5):401-404.
[16]Ang TW.The effectiveness of corticosteroid injection in the treatment of plantar fasciitis[J].Singapore Med J,2015,56(8):423-432.
[17]Sherpy NA,Hammad MA,Hagrass HA,et al.Local injection of autologous platelet rich plasma compared to corticosteroid treatment of chronic plantar fasciitis patients:a clinical and ultrasonographic follow-up study[J].The Egyptian Rheumatologist,2016,38(3):247-252.
[18]JiménezPérez AE,GonzalezArabio D,Diaz AS,et al.Clinical and imaging effects of corticosteroids and platelet-rich plasma for the treatment of chronic plantar fasciitis:A comparative non randomized prospective study[J].Foot Ankle Surg,2019,25(3):354-360.
[19]Chen YJ,Wu YC,Tu YK,et al.Autologous blood-derived products compared to corticosteroids for treatment of plantar fasciopathy:A systematic review and meta-analysis[J].Am J Phys Med Rehabil,2019,98(5):343-352.
[20]Johnson-Lynn S,Cooney A,Ferguson D,et al.A feasibility study comparing platelet-rich plasma injection with saline for the treatment of plantar fasciitis using a prospective,randomized trial design[J].Foot Ankle Spec,2019,12(2):153-158.
[21]Eslamian F,Shakouri SK,Jahanjoo F,et al.Extra corporeal shock wave therapy versus local corticosteroid injection in the treatment of chronic plantar fasciitis,a single blinded randomized clinical trial[J].Pain Med,2016,17(9):1722-1731.