Daher M, Covarrubias O, Herber A, et al. Platelet-Rich Plasma vs Extracorporeal Shock Wave Therapy in the Treatment of Plantar Fasciitis at 3-6 Months: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Foot Ankle Int. 2024 Feb 28:10711007241231959. doi: 10.1177/10711007241231959. (Systematic review)

BACKGROUND: Plantar fasciitis (PF) is a common foot disorder with variability in treatment strategy. Two effective management techniques include platelet-rich plasma (PRP) injections and extracorporeal shock wave therapy (ESWT). The purpose of this meta-analysis is to compare the effectiveness of PRP vs ESWT in the management of PF.

METHODS: A systematic search was performed of PubMed, Cochrane, and Google Scholar for randomized controlled trials comparing PRP to ESWT. Studies met inclusion criteria if mean and SDs for visual analog scale (VAS) pain scores and plantar fascia thickness (PFT) were reported. Mean differences were used to compare VAS pain score and PFT between PRP and ESWT.

RESULTS: Six randomized controlled trials, comparing a total of 214 subjects in the PRP group and 218 subjects in the ESWT group, were analyzed. A significantly greater statistical improvement was seen in the PRP group in VAS pain (mean difference = -0.67 [95% CI -1.16, -0.18], P = .007) and plantar fascia thickness (PFT) (mean difference = -0.56 [95% CI -0.77, -0.35], P < .001).

CONCLUSION: PRP had a statistically higher pain reduction than ESWT, but the difference does not reach clinical significance in this meta-analysis.

Discipline Area Score
Physician 5 / 7
Rehab Clinician (OT/PT) 5 / 7
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Comments from MORE raters

Rehab Clinician (OT/PT) rater

Study results are clinically unimportant and, as the authors pointed out, sample sizes were very small to draw any definitive conclusions. As a physical therapist, I believe the study will not impact my treatment for plantar fasciitis until further research with low bias are published.
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