Clinical Outcomes Following Platelet-Rich Plasma Injection for Plantar Plate Injuries at Midterm Follow-up.

Abstract

Evidence supporting platelet-rich plasma (PRP) injection for plantar plate injuries remains limited. To evaluate patient-reported outcomes, return to activity, complications, and failures at midterm follow-up in patients with plantar plate injuries treated with PRP injection. Retrospective case series evaluating outcomes following PRP injection for plantar plate injuries. Patients with plantar plate injuries were treated with ultrasound-guided PRP injection following failure of nonoperative management. Clinical outcomes evaluated were Foot and Ankle Outcome Score (FAOS) and Visual Analog Scale (VAS). Complications and failures were also reported. Twenty patients (23 feet) with a mean age of 51.0 ± 14.5 years and mean follow-up time of 58.0 ± 28.4 months were included. Mean FAOS scores improved 32.2 points (p < 0.001), with 20 of 23 (87%) feet achieving the minimal clinically important difference (MCID). Mean VAS scores improved 4.5 points (p < 0.001), with 19 of 23 (83%) feet achieving the MCID. Among 10 athletes, 7 (70%) returned to sport at a mean time of 3.1 ± 1.1 months. Complications occurred in 1 of 23 (4%) feet, and 3 of 23 (13%) feet required subsequent surgical intervention. At midterm follow-up, PRP injection for plantar plate injuries was associated with significant clinical improvement and a favorable safety profile, suggesting a potential role as an intermediary treatment option between conservative management and surgery. Female sex, smoking history, and higher-grade injuries were associated with inferior outcomes, underscoring the importance of individualized patient counseling and injury severity assessment. IV, retrospective case series.