Platelet-rich plasma for foot and ankle pathologies: A systematic review

Background: The aim of this article is to review systematically all the literature available on the clinical application of PRP for the treatment of foot and ankle pathologies, to understand its potential and best indications for clinical use. Methods: A systematic search of the PubMed database was performed. Research criteria were the following: (1) papers in the English language, (2) dealing with the clinical application of PRP for the treatment of orthopedic-related conditions affecting the foot and ankle district, (3) with I to IV level of evidence, and (4) reporting clinical results. Results: A total of 17 studies fulfilled the inclusion criteria. Nine papers dealt with Achilles tendon management, 2 articles with plantar fasciitis, 3 papers with talar osteochondral lesions, 2 with PRP application in total ankle replacement, and 1 article with PRP in foot and ankle fusions. The overall evaluation of the results reported does not clearly demonstrate the potential of PRP treatment in any of the specific fields of application. Conclusions: Considering the literature currently available, no clear indications for using PRP in the foot and ankle district emerged. Level of evidence: Level IV, systematic review of Level I, II, III and IV studies. (C) 2013 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.