PRP vs Corticosteroids for Plantar Fasciitis: Systematic Review of 9 RCTs
Hurley ET · Orthopaedic Journal of Sports Medicine (2020)
DOI: 10.1177/2325967120915704This meta-analysis pooled 9 RCTs comparing PRP to corticosteroid injections specifically for plantar fasciitis, totaling 479 patients. PRP was statistically superior to corticosteroid at every measured timepoint from 1 month through 12 months for VAS pain scores, and at 6 and 12 months for AOFAS functional scores. The consistency of benefit across timepoints and outcome measures makes this one of the strongest evidence bases for PRP in any orthopedic condition.
Clinical Relevance
Strong support for PRP as a first-line injection therapy for plantar fasciitis, particularly when corticosteroid risks (fascia rupture, fat pad atrophy) are a concern. The sustained benefit pattern makes PRP especially attractive for chronic cases.
Key Takeaways
- PRP superior to corticosteroid at ALL VAS timepoints (1, 3, 6, 12 months; all p<0.004)
- AOFAS functional scores superior at 6 and 12 months (p<0.00001)
- 9 RCTs, 479 patients (robust evidence base)
- Corticosteroid comparator (not placebo), making the clinical comparison directly relevant
- Remarkably consistent results across heterogeneous study designs
Key Findings
9 RCTs (239 PRP vs 240 CS). PRP superior at all VAS timepoints (p<0.00001 at 3,6,12mo). AOFAS superior at 6 and 12 months.
Clinical Context
Study Design
Systematic Review and Meta-Analysis
Condition
Chronic Plantar Fasciitis
Sample Size
479 patients
Follow-up
12 months
Control Group
Corticosteroid (methylprednisolone or triamcinolone)
Primary Outcome
VAS, AOFAS
PRP Protocol & Intervention
Preparation System
Various
Platelet Concentration
Only 1/9 reported minimum concentration
Injection Frequency
1 injection(s)
Guidance Method
Only 2/9 used ultrasound