Ultrasound-guided local injection: autologous blood versus dexamethasone for treatment of recurrent plantar fasciitis

ABSTRACT

To compare the efficacy of Ultrasound-guided local autologous blood injection to Ultrasound-guided local dexamethasone injection for treatment of recurrent Plantar fasciitis. Nineteen consecutive patients with recurrent refractory plantar fasciitis were recruited into the study following informed consent. Patient were assessed by numerical visual analogue scale [VAS], heel tenderness index [HTI], laboratory investigations, and heel ultrasound scanning. Eight patents had ultrasound guided local autologous blood injection as a treatment modality [Group I], while the other eleven patients had ultrasound guided local dexamethasone injection [Group II]. After care was given and patients were monitored at one week, four weeks, three months, and six months by the previous evaluation parameters. Demographic and some clinical characteristics of groups showed non significant differences at base line. Follow up and monitoring showed improvement of symptoms in both groups. Follow up of VAS, HTI, the planter fascia thickness, echogenicty and percentage of mean change [m c%] at 6 months compared to base line measurements reveled highly significant difference in for Group I and Group II. The mean change percentage decrement for Group II was less than that for Group I. Comparison between Group I and Group II as regards the evaluation parameters at the end of six months showed significant difference and better symptom improvement for Group I except for lat band thickness. Autologous blood injection appears to be a viable alternative to steroid injection therapy for treatment of recurrent plantar fasciitis. It appears to be safe and no reports of reflex sympathetic dystrophy, infection or other major complications