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Rheumatology (Oxford). 2015 Sep;54(9):1735-43. doi: 10.1093/rheumatology/kev010. Epub 2015 Apr 6.

Comparative effectiveness of autologous blood-derived products, shock-wave therapy and corticosteroids for treatment of plantar fasciitis: a network meta-analysis.

Author information

1
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch and National Taiwan University College of Medicine, Taipei.
2
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Chu-Tung Branch, Hsinchu.
3
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch and National Taiwan University College of Medicine, Taipei, Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, pattap@pchome.com.tw.
4
Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Department of Internal Medicine and.
5
Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health.
6
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Abstract

OBJECTIVE:

To compare the efficacy of autologous blood-derived products (ABPs), CSs and shock-wave (SW) therapy in the treatment of plantar fasciitis.

METHODS:

Electronic databases were searched for studies that compared ABPs, CSs and SW therapy for the treatment of plantar fasciitis, published up to June 2014. The primary and secondary outcomes were reduction in visual analogue scale (VAS) score at 3 and 6 months and odds ratio of treatment success, respectively. Groups were compared by traditional pair-wise meta-analysis and by network meta-analysis.

RESULTS:

Seven randomized controlled trials and three quasi-experimental studies that included 604 patients were enrolled. Pair-wise meta-analysis indicated a trend favouring ABPs over CSs regarding VAS reduction at 3 months; this benefit was significant in a subgroup analysis of platelet-rich plasma (PRP) vs CSs. There were no significant between-group differences in VAS reduction at 6 months and in treatment success. Network meta-analysis showed that ABPs had the highest probability of being the best treatment at 3 months, but ABPs were slightly inferior to SW for VAS reduction at 6 months. Although SW therapy had the highest likelihood of treatment success, the between-group differences in probabilities were less remarkable than those for pain reduction at 3 and 6 months.

CONCLUSION:

ABPs, followed by CSs, were best in providing relief from pain at 3 months. SW therapy and ABPs had similar probabilities of providing pain relief at 6 months, and were better than CSs at that time. Subgroup analysis indicated that an ABP regimen consisting of platelet-rich plasma improves treatment efficacy.

KEYWORDS:

autologous blood-derived products; corticosteroid; plantar fasciitis; platelet-rich plasma; shock-wave therapy

PMID:
25848072
DOI:
10.1093/rheumatology/kev010
[Indexed for MEDLINE]

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