The Effect of Platelet-Rich Plasma (PRP) Injection in the Treatment of Plantar Fasciopathy

Abstract

lantar fasciopathy is a frequent disorder involving the plantar fascia. It has a bimodal distribution and occurs in both athletes and sedentary subjects. Usually, syndromes that involve manifestation of the typical heel pain are called plantar fasciitis, but that term is not correct, because no histological evidence of inflammation is present in this condition; the terms ‘fasciosis’ or ‘fasciopathy’ are most appropriate terms to define heel pain associated with degeneration of the plantar fascia and atrophy of the Abductor digiti minimi muscle. Muscle, tendon, ligament, and bone recover from injury in a stepwise manner depending upon the inflammatory process. The three phases of this process include bleeding/ inflammation, fibroblastic proliferation, and maturation of the differentiated cells into a mature scar. In proximal plantar fasciitis, and other enthesopathies, repetitive overload on the tissues allows for insufficient time for recovery to occur. The result is degeneration of the fibroblasts along with chronic inflammatory change. The tissues cannot properly remodel and a dense inelastic scar forms, not well suited to proper function. Growth factors play an integral role in the natural process of healing. They promote the inflammatory response allowing the completion of one phase and progression to the next. In phase1, bleeding into the area of injury causes platelet aggregation then coagulation so as to prevent excessive bleeding and to release growth factors.