University of Pittsburgh researchers have actually developed a new procedure to treat an uncomfortable foot condition called plantar fasciitis. A clients own fat is injected into the foot by means of lots of small injections in a grid pattern. About 10% of clients progress to the chronic type in which the foots collagen degenerates and the plantar fascia thickens. For these clients, surgical release of the plantar fascia with a small cut can help, however this surgery comes with dangers, according to Beth Gusenoff.
” In fat, there are stem cells and development elements that help bring in fresh blood supply, which drives a mode of wound recovery with lowered scarring,” explained Jeffrey Gusenoff.
Jeffrey Gusenoff, M.D., teacher of cosmetic surgery at the University of Pittsburgh. Credit: UPMC
” We established this procedure to harness the regenerative homes of fat,” said Jeffrey Gusenoff, M.D., teacher of cosmetic surgery at Pitt. “In this proof-of-concept research study, we revealed that fat injections into the foot reduced heel discomfort, helped clients get back to doing activities and sports and increased lifestyle.”
Plantar fasciitis, or PF, is among the most typical reasons for heel discomfort, affecting about 2 million people in the United States. Its triggered by swelling of the plantar fascia, connective tissue that ranges from the heel to the toes and supports the foot arch.
” Plantar fasciitis is exceptionally unpleasant,” stated Beth Gusenoff, D.P.M., scientific assistant teacher of plastic surgical treatment at Pitt. “When you get up from a sitting position or from sleeping, its a sharp, searing pain that some people describe as being like a nail going right through their heel.”
The acute type of PF can be treated with extending, shoe orthotics or cortisone injections. About 10% of clients progress to the chronic kind in which the foots collagen deteriorates and the plantar fascia thickens. For these clients, surgical release of the plantar fascia with a small cut can help, however this surgical treatment includes threats, according to Beth Gusenoff.
” Recently, there has actually been a plea amongst podiatric doctors to stop cutting the plantar fascia due to the fact that some people get a great deal of scar tissue, which causes pain,” she explained. “And if too much is cut, the foot can become destabilized, so people end up with practically like a floppy foot.”
Influenced by the regenerative properties of fat stem cells, the Gusenoffs established a strategy that uses fat gathered from a clients stubborn belly or other body location.
Beth Gusenoff, D.P.M., scientific assistant professor of cosmetic surgery at the University of Pittsburgh. Credit: UPMC
” In fat, there are stem cells and growth aspects that assist generate new blood supply, which drives a mode of wound healing with minimized scarring,” explained Jeffrey Gusenoff. “We utilize a blunt needle to bore the plantar fascia, which makes a little injury to promote the healing process. When we pull the needle back, we inject a little bit of the clients fat.”
To check this technique, the group hired 14 patients with persistent PF and split them into 2 groups. Group 1 participants received the procedure at the beginning of the research study and were followed for 12 months, and their Group 2 equivalents received the procedure after a six-month observation duration and were followed for an additional six months.
” We found that Group 1 had enhancements in lifestyle and sports activity, decreased plantar fascia thickness and lowered pain levels,” said Jeffrey Gusenoff. “And a great deal of the steps that were enhancing six months after the procedure got back at better by 12 months.”
Group 2 revealed reduced plantar fascia thickness and increased sports activity six months after the treatment, and there was a small, but not statistically significant, enhancement in discomfort levels. With a larger sample size and a longer follow-up time, the researchers stated its most likely they would have seen stronger improvements in this group.
According to the Gusenoffs, this study provides proof-of-concept that fat injections can deal with PF, and they now are planning a larger medical trial to verify these findings. With enough evidence, they hope that the procedure will be considered a medical need so that it can be covered by insurance coverage and become more widely readily available in the future.
In previous work, the Gusenoffs showed that fat injections can help fix another type of foot pain brought on by loss of the fat pads that cushion the ball of the foot and heel.
Recommendation: “Perforating Fat Injections for Chronic Plantar Fasciitis: A Randomized, Cross-over Clinical Trial” 25 January 2022, Plastic and Reconstructive Surgery.
Danielle Minteer, Ph.D., previously of Pitt, was an extra author of this study.
This research was supported by the Virginia Kaufman Pain Research Challenge.
University of Pittsburgh researchers have established a new treatment to treat an unpleasant foot condition called plantar fasciitis. A clients own fat is injected into the foot via dozens of small injections in a grid pattern. Credit: Beth Gusenoff and Jeffrey Gusenoff
A novel method that transplants a clients own fat into the sole of their foot might offer relief to those experiencing a painful and typical condition called plantar fasciitis, according to University of Pittsburgh School of Medicine scientists.
In a pilot study, published today in Plastic and Reconstructive Surgery and led by a wife-and-husband group, the fat injection procedure enhanced symptoms of plantar fasciitis in patients, preparing for a larger medical trial.