Plantar fasciitis is one of the most common foot conditions presenting to a foot and ankle specialist. Surgical treatment outcomes following plantar fasciotomy vary but short-term studies have reported excellent early pain relief and significant improvements in symptoms. This study evaluates patient reported outcome scores collected pre- and post-op for patients who underwent percutaneous ultrasonic micro-tenotomy (PUT) plantar fasciotomy with PRP injection vs PUT plantar fasciotomy alone. 

Chart review data was collected on pain Visual Analog Scales (VAS), for patients treated surgically (plantar fasciectomy) by Orthopaedic Surgery department foot & ankle faculty members between December 2007 and December 2022. A total of 30 patients were identified. Exclusion criteria were patients younger than 18 years old and patients who had undergone plantar fasciectomy without the use of PUT or those who had undergone PUT but did not complete their pain VAS surveys. All statistical analyses were carried out using SAS 9.4 (SAS Inc., Cary, NC, USA). Descriptive statistics (mean, standard deviation, median, range, frequency, and percentage) were employed for summarizing measurements. Paired t test and two-sample t test were conducted to compare the measurements. Fisher’s exact test was used to compare gender distribution. The level of significance was set at 5%. 

Patients who received PUT with PRP had a statistically significant decrease in pain level compared to the PUT without PRP group. There was a significant decrease in pain level from pre-op visit (at least 1 month prior to operation) to last follow-up visit. The mean pain VAS at the pre-op visit was 7.69, with a standard deviation (SD) of 2.26 and the mean pain VAS at the last follow-up visit was 4.85, with a SD of 2.75. A paired t-test paired showed there was significant difference between pre-op and post-op pain VAS for each group, with a p-value of <0.0001. The pain VAS change in the PUT with PRP group was significantly larger than in the PUT without PRP group, a paired t-test yieled a p-value of <0.0325. The mean time between the initial visit and last follow-up visit was 19 months. The mean time following surgical intervention was 10 months. 

In the literature, most studies have found that PUT or PRP individually were successful in producing clinically and statistically significant improvements in pain and quality of life. However, there are limited studies looking at the synergistic use of PUT & PRP to show their combined impact on patient outcomes and pain relief. The findings of our study suggest that the dual use of PUT & PRP treatments could potentially lead to an increase in the longevity of pain relief.

Retrospective Evaluation of Ultrasound Guided Percutaneous Plantar Fasciotomy With and Without Platelet Rich Plasma

 Orthopaedic Surgery

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Retrospective Evaluation of Ultrasound Guided Percutaneous Plantar Fasciotomy With and Without Platelet Rich Plasma

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