The role of corticosteroid injections in treating plantar fasciitis: A systematic review and meta-analysis |
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| Institution: | 1. Department of Surgery, Peninsula Health, Victoria 3199, Australia;2. Faculty of Medicine and Science, Central Clinical School, Monash University, Victoria 3004, Australia.;3. Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, New South Wales 2500, Australia;4. Faculty of Science, Medicine and Health, University of Melbourne, Victoria 3010, Australia;5. Department of Orthopaedic Surgery, The Alfred Hospital, Melbourne, Victoria 3004, Australia;6. Department of Orthopaedic Surgery, Box Hill Hospital, Melbourne, Victoria 3128, Australia;1. Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan;2. Department of Physical Therapy, Faculty of Health Science, Kio University, Japan;3. Graduate School of Science and Technology, Keio University, Japan;4. Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Japan;1. Orthopaedic Department, Benha University, Egypt;2. Orthopaedic Department, National Institute of Neuromotor System, Egypt;3. Orthopaedic Department, Mansoura University, Egypt;4. Orthopaedic Department, Qena faculty of medicine and University Hospital, South Valley University, Qena, Egypt;1. College of Health Sciences, University of Abuja, Abuja, Nigeria;2. Memorial Hermann Southwest Hospital, Houston, TX, United States;3. Andrew Clarke Podiatry Clinic, Suite 315, Library Square, Wilderness Road, Claremont, Cape Town 7708, South Africa;4. Muhimbili University College of Health Science and Abbas Medical Centre, P O Box 21361, Dar es Salaam, Tanzania;5. Mark Anumah Medical Mission, Abuja, Nigeria;1. Graduate School of Health Sciences, Sapporo Medical University, Japan;2. Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, Sapporo, Japan;3. Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Hokkaido, Japan;1. Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, 529889, Singapore;2. Department of Epidemiology, Singapore Clinical Research Institute, 31 Biopolis Way, 138669, Singapore;3. Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea |
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| Abstract: | BackgroundPlantar fasciitis is a recurrent cause of heel pain and is often treated by corticosteroid infections (CSI). The current study reviewed and analysed the role of CSI with platelet rich plasma (PRP), and CSI with extracorporeal shock wave therapy (EWST) for plantar fasciitis treatment.MethodsPubMed, Medline, Web of Science, Embase, Cochrane, and Google Scholar databases were searched for relevant studies. Preferred Reporting in Systematic Review & Meta-Analysis (PRISMA) guidelines were used to search relevant studies published from infinity to April 2021. The risk of bias was performed using Cochrane Collaboration’s tool. GRADE assessment was used for quality of evidence. Data analysis was performed with the use of R software and P < 0.05 was considered statistically significant. CSI was compared with PRP and EWST.ResultsEighteen studies comprising 1180 patients were included in this meta-analysis. When compared to PRP, CSI with lignocaine/lidocaine had significantly higher mean difference on visual analogue scale (VAS) pain scores at 3 months (0.62 0.13; 1.12], P = 0.01) and 6 months (MD = 1.49 0.22; 2.76], P = 0.02). At 6 months, VAS scores were higher in the CSI group than the ESWT group (MD = 0.8 0.38; 1.22], P = 0.1). At 6 months, a significant reduction in the American Orthopaedic Foot and Ankle Score (AOFAS) was observed in the CSI group compared to PRP (MD = − 11.53 − 16.62; − 6.43], P < 0.0001).ConclusionPatients suffering from plantar fasciitis, PRP achieved better VAS scores compared to CSI at 3 and 6-month follow-up. In addition, ESWT had better VAS score outcomes at 6 months compared to CSI. Regarding AOFAS score, PRP was more efficacious than CSI at 6 months of follow-up. Only through the development of high-quality, large-scale longitudinal studies, will the findings and conclusions of this meta-analysis be strengthened and influence our clinical practice in the treatment of plantar fasciitis.Level of clinical evidenceII. |
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| Keywords: | Plantar fasciitis Plantar heel pain Corticosteroid injections Platelet rich plasma |
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