European Journal of Molecular & Clinical Medicine

Background: People will get plantar fasciitis or fasciopathy nearly 10% in their lifetime, which affects the plantar fascia and causes abnormal thickening and structure. Most patients will be healed within 6 to 12 months, however other people can experience symptoms for much longer. The main aim of this study was to compare the effects of corticosteroid and platelet rich plasma (PRP) for the treatment of plantar fasciitis. Methods: The present study was conducted in department of orthopaedics at tertiary care centre Chengalpattu district. In this study, Sampling for the selection of study subjects with Randomisation for the allocation of interventions. Total of 60 both in patients and out patients with plantar fasciitis with the age group between 30 to 50 years, were treated with corticosteroids and platelet rich plasma (PRP), for 18 months. Thirty patients were treated with platelet rich plasma. The platelet rich plasma (PRP) was prepared from venous whole blood. The other thirty patients were treated with corticosteroid injection. The primary analysis included visual analogue scale (VAS) pain scores and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hind foot outcome scores. Results: The PRP group was more often successfully treated than the corticosteroid group. When baseline VAS and AOFAS scores were compared with the scores at 12 weeks follow up, both groups showed improvement across time (intention-to-treat principle). The mean VAS and AOFAS heel pain scores measured 6 weeks after treatment were 77.5 in steroid group and 87.5 in PRP group, and the scores in both groups were significantly lower when compared with pre-treatment levels.  PRP treatment was more effective resulted higher improvement in VAS score and in AOFAS score at 6 weeks as compared to steroid injection (P value<0.001). Conclusion: Treatment of patients with plantar fasciitis with PRP reduces pain and increases function significantly, exceeding the effect of corticosteroid injection at the end of 6 weeks. Hence, we concluded that PRP injection is more effective in resulting pain relief and function as compared to corticosteroid injection.

Background: Traditionally Open Z-Plasty lengthening is the choice of the procedure for
treating Achilles tendon contracture seen in equinus deformity of the foot, which is
commonly seen in club foot, spastic cerebral palsy, polio myelitis, post traumatic and post
burn contractures etc. Percutaneous Achilles tendon lengthening by triple level tenotomy
technique is based on sliding of partially cut tendon preserving its biology, strength and
biomechanics. This study aims to evaluate the efficacy and safety of this new surgical
therapeutic method.
Methods: A retrospective analysis of the Achilles tendon contracture cases in our hospital
between 2015 and 2020 was conducted. Fifty-one cases of equinus deformities treated with
percutaneous triple level Achilles tendon tenotomy. Operative time required, hospital stay,
wound healing, Achilles tendon rupture and equinus recurrence were recorded and
statistically analysed. American Orthopaedic Foot & Ankle Society (AOFAS) scoring system
was used to assess the Foot and ankle function.
Results: The mean follow-up period was 20 months. The mean operative time was 6 minutes
and mean hospital stay was 2 days. No cases had infection or wound healing complications.
One patient had equinus recurrence which was minimal. The mean AOFAS score increased
from 53% points before procedure to 96% at final follow-up.
Conclusion: This method of Achilles tendon lengthening by Triple level percutaneous
tenotomy significantly reduces operative time, hospital stay and thus expenses. Also this
technique is much better in maintaining soft tissue biology, strength and biomechanics thus
helping in preventing rupture of the tendon and recurrence of the deformity.