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A Retrospective Clinical Evaluation of the Use of Placental Tissue Matrix in Patients with Chronic Plantar Fasciitis
Jeffrey D Loveland
Background: Plantar fasciitis is a common cause of foot and heel pain, affecting over one million people yearly in the United States. Most patients with plantar fasciitis respond favorably to conservative treatments, but these are ineffective in 10-15% of patients. A more invasive option is surgery with the use of placental tissue allograft to supplement/replace damaged or inadequate connective tissue.
Methods: This single-site, retrospective, consecutive case series evaluated safety and efficacy of flowable placental tissue matrix (PTM) in 67 procedures of 65 patients with chronic plantar fasciitis along with partial plantar fasciotomy. Inclusion criteria consisted of plantar fasciitis; failure of ≥ 3 conservative treatments; partial fasciotomy with flowable PTM; and ≥ 12 months follow-up. The primary outcomes were time to pain-free ambulation and the change in visual analog scale pain score. The secondary outcome was duration of heel pain. All patients underwent partial plantar fasciotomy with injection of 2.0 ccs of flowable PTM into the damaged connective tissues.
Results: The mean preoperative visual analog scale (VAS) pain score was 6.72 ± 0.90 (range from 4 to 8). The mean postoperative VAS score at 4 weeks was 0.37 ± 0.79, demonstrating a 94.49% decrease in pain (P<0.001), and at 12 weeks was 0.09 ± 0.38, a 98.66% decrease in pain (P<0.001). Seven patients (10.45%) in the study required additional intervention following application of the flowable PTM with fasciotomy. The average duration of plantar heel pain prior to surgery was 9.48 months (range from 2 to 36 months).
Conclusion: Overall we found that patients with recurrent heel pain secondary to plantar fasciitis reported a significant decrease in pain from prior to surgery to both four and twelve weeks postoperatively. Patients also experienced improved functional recovery following plantar fasciotomy with application of flowable PTM