PRP vs All Modalities for Plantar Fasciitis: Meta-Analysis of 21 RCTs
Tung WS · Foot and Ankle Surgery (2024)
DOI: 10.1016/j.fas.2024.02.001The largest plantar fasciitis meta-analysis at its publication date, this study analyzed 21 RCTs with 1356 patients comparing PRP against multiple treatment modalities including corticosteroids, ESWT (extracorporeal shock wave therapy), and placebo. PRP demonstrated superiority over all comparators for VAS pain, with particularly large effect sizes against placebo and meaningful advantages over both ESWT and corticosteroids.
Clinical Relevance
Positions PRP as the most effective injection therapy for plantar fasciitis across all available comparators. The superiority over ESWT is particularly notable since ESWT is often considered a strong non-invasive option. Supports PRP as the preferred injection when conservative measures fail.
Key Takeaways
- PRP vs placebo: massive effect (SMD=3.42, p<0.00001)
- PRP vs corticosteroid: significant (SMD=1.08, p=0.04)
- PRP vs ESWT: significant (SMD=0.86, p=0.002)
- 21 RCTs, 1356 patients (comprehensive coverage)
- PRP superiority held against every comparator tested
Key Findings
PRP superior to ESWT (SMD=0.86, p=0.002), CS (SMD=1.08, p=0.04), placebo (SMD=3.42, p<0.00001).
Clinical Context
Study Design
Systematic Review and Meta-Analysis
Condition
Plantar Fasciitis
Sample Size
1356 patients
Control Group
CS, ESWT, Placebo
Primary Outcome
VAS, FFI, AOFAS
PRP Protocol & Intervention
Preparation System
Various across 21 RCTs