PRP vs Cortisone for Chronic Severe Plantar Fasciitis: Single-Blind RCT
Monto RR · Foot & Ankle International (2014)
DOI: 10.1177/1071100713519778This single-blind RCT compared a single PRP injection to a single cortisone injection in 40 patients with chronic severe plantar fasciitis who had failed at least 12 months of conservative treatment. The study captured the classic divergent trajectory: corticosteroid provided rapid relief peaking at 3 months that then deteriorated, while PRP showed progressive improvement that was sustained at 24 months. AOFAS scores in the PRP group went from 37 to 95, representing near-complete resolution.
Clinical Relevance
One of the most compelling individual RCTs for PRP in plantar fasciitis. The 24-month follow-up captures what shorter studies miss: the corticosteroid relapse pattern and sustained PRP benefit. This study is essential for patient counseling about expected timelines.
Key Takeaways
- PRP: AOFAS improved from 37 to 95 at 24 months (p<0.001), near-complete resolution
- Corticosteroid: initial improvement then relapse by 12 to 24 months
- PRP and corticosteroid trajectories crossed at approximately 6 months
- All patients had failed >12 months of conservative care (truly refractory population)
- Same author (Monto) who published positive Achilles case series, demonstrating consistent methodology
Key Findings
PRP AOFAS 37->95 at 24mo (p<0.001). CS improved at 3mo then deteriorated. PRP sustained; CS relapsed.
Clinical Context
Study Design
Prospective Randomized Single-Blind
Condition
Chronic Severe Plantar Fasciitis (>12mo)
Sample Size
40 patients
Follow-up
24 months
Control Group
Cortisone (40mg methylprednisolone)
Primary Outcome
AOFAS Ankle-Hindfoot Score
PRP Protocol & Intervention
Injection Volume
3 mL
Injection Frequency
1 injection(s)
Guidance Method
Palpation-guided