Outcomes of platelet-rich plasma for plantar fasciopathy: a best-evidence synthesis

Tao Yu, Jiang Xia, Bing Li, Haichao Zhou, Yunfeng Yang, Guangrong Yu, Tao Yu, Jiang Xia, Bing Li, Haichao Zhou, Yunfeng Yang, 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: Corticosteroid; Fasciopathy; Platelet-rich plasma; Therapy.

Conflict of interest statement

The authors declare they have no competing interests

Figures

Fig. 1
Fig. 1
Flow chart outlining the process of study identification, inclusion, and exclusion
Fig. 2
Fig. 2
Forest plot of VAS in the PRP group compared with the CS group from the 6-month follow-up
Fig. 3
Fig. 3
Forest plot of AOFAS in the PRP group compared with the CS group from the 6-month follow-up
Fig. 4
Fig. 4
Forest plot of subgroup analysis of VAS of the different levels in methodology
Fig. 5
Fig. 5
Forest plot of subgroup analysis of AOFAS of the different levels in methodology
Fig. 6
Fig. 6
Forest plot of VAS in the PRP group compared with the PL group

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