Therapeutic Efficacy of Platelet-Rich Plasma Injection Compared to Corticosteroid Injection on Pain and Function in People with Plantar Fasciitis: An Overview and Update of Systematic Reviews

Platelet-rich plasma (PRP) and corticosteroid injection is frequently used for the treatment of people with plantar fasciitis (PF). However, compared with corticosteroid steroid injection, the clinical results of PRP for PF patients remain controversial. Objective: This study aimed to critically analyze, summarize, and update the existing evidence from published systematic reviews (SRs) and meta-analyses of randomized controlled trials (RCTs) to determine whether PRP injections are associated with improved pain and function scores when compared with corticosteroid injections for people with PF.

Overview of systematic reviews. Data Sources: Electronic databases (Cochrane library, PubMed, and EMBASE) were searched. Two reviewers assessed the quality of SRs using the AMSTAR-2 tool and evaluated the strength of evidence quality with the grading of recommendations, assessment, development, and evaluation (GRADE) system for relevant outcome measures. Mean difference (MD) and 95% confidence intervals (CIs) were calculated.

15 SRs (with 25 studies) met the study criteria. No difference was observed at short and medium-term for pain and function outcomes. In addition, in long-term PRP is like corticosteroid injections for function outcome. The meta-analysis showed a significant improvement in pain of -1.78 (95% CI: -3.42 to -0.14, I² = 99%) for participants in the PRP group compared with the corticosteroid injection group.

Compared to corticosteroids injections, PRP showed significantly better pain control only at long-term follow-up. No difference was observed at short and medium-term for pain and function outcomes.