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

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, I(2) = 85%; AOFAS: MD = 10.05, P < 0.0001, I(2) = 85%), whereas there is no statistical difference in well-designed double-blind trials (VAS: MD = 0.15, P = 0.72, I(2) = 1%; AOFAS: MD = 2.71, P = 0.17, I(2) = 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.