Platelet-Rich Plasma Versus Corticosteroids in the Treatment of Plantar Fasciitis: A Systematic Review and Meta-Analysis.

Objective: This study aims to compare the efficacy of platelet-rich plasma (PRP) and corticosteroids (CS) in treating plantar fasciitis, focusing on pain relief, foot function, and plantar fascia thickness to identify the optimal treatment approach.

Design: A comprehensive search of medical databases was conducted following PRISMA guidelines, utilizing an extensive keyword strategy. Inclusion criteria encompassed prospective RCTs involving adult patients with plantar fasciitis treated with local PRP or CS injections, specifically assessing outcomes such as the Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) scores, and plantar fascia thickness.

Results: The meta-analysis included 24 RCTs with 1653 participants. PRP injections yielded significantly better VAS scores compared to CS injections at 3 months (P = 0.03) and 6 months (P < 0.001), with no significant differences at 1 month (P = 0.12) and 12 months (P = 0.08). AOFAS scores demonstrated that PRP was superior to CS at 3 (P = 0.05), 6 (P < 0.001), and 12 months (P < 0.001), with no significant differences at 1 month (P = 0.31). Regarding plantar fascia thickness, there were no significant differences between PRP and CS at 1-1.5 months (P = 0.18), 3 months (P = 0.64), and 6 months (P = 0.05).

Conclusions: PRP injections offer superior pain control compared to corticosteroids in the medium term (3-6 months) but not in the short term or at one year.