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Τρίτη 23 Οκτωβρίου 2018

Autologous blood-derived products compared to corticosteroids for treatment of plantar fasciopathy: a systematic review and meta-analysis

Objective This review article evaluated the efficacy of autologous blood-derived products (ABPs), including whole blood (WB) and platelet-rich plasma (PRP), in reducing pain and improving function compared with corticosteroids (CS) for plantar fasciopathy (PF) patients. Design Literature comparing ABP and CS for the treatment of PF was systematically reviewed. Twelve randomized controlled trials (RCTs) and four quasi-experimental studies were included. The visual analogue scale pain score and American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score were evaluated at 1.5, 3, and 6 months' follow-up. Subgroup analyses were performed concerning PRP preparation techniques, injection regiments, and study designs. Results CS was found to reduce pain more effectively than WB at 1.5 months and 3 months, but the effect disappeared at 6 months. PRP reduced pain more effectively at 6 months post-injection than CS. However, there was no significant difference in the AOFAS score between PRP and CS injections at any time point. In the subgroup analyses, pain was significantly reduced at 6 months by self-prepared PRP, one-step separation PRP, PRP of more than 3 mL, and PRP without local analgesics. Conclusion The results of this meta-analysis suggest that PRP may provide a long-term effect in relieving pain in PF patients. #These two authors contribute equally to the work Corresponding author: Tung-Yang Yu, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, 5, Fushing Street, Kuei-Shan District, Taoyuan City 33305, Taiwan, Tel: +886-3-3281200 ext 3846; Fax: +886-3-3281320; E-mail: mr3964@cgmh.org.tw Author disclosures The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. No party has direct interest neither a financial relationship nor will they be conferred any benefits from writing this submission or the results of this research. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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