Joost Peerbooms

142 Chapter 9 pain scores at 1 year follow-up than the corticosteroid- group (mean difference, 14.4; 95% CI, 3.2-25.6). At 1 year follow-up, 39 of the 46 patients in the PRP-group (84.4%) had an improved pain score of at least 25%. In the corticosteroid-group 20 out of the 36 patients (55.6%) had an improvement of their pain scores by at least 25% ( P = .003). The PRP-group also showed significantly lower FFI Disability scores than the corticosteroid- group (mean difference, 12.0; 95% CI, 2.3-21.6). Treatment of chronic plantar fasciitis with PRP appears to have a better effect than corticosteroid treatment on pain and function. In Chapter 8 the outcomes of our PRP work are reviewed to evaluate the performance of PRP in the treatment of some musculoskeletal disorders. Based on the studies presented in this thesis, our conclusion is that PRP injection outperforms corticosteroid injection when used for tennis elbow and plantar fasciitis. However, this does not definitively prove the positive effect of PRP injections. Negative effects of corticosteroid injections have been found, creating a bias towards the effectiveness of PRP. Future studies should form a real control group. Over the last few decades, PRP has made a place for itself in orthopaedic surgery and sports medicine. However, until now, studies regarding PRP have often been of limited quality. We recommend that future studies provide a detailed, precise, and stepwise description of the PRP preparation protocol used. Moreover, a standardised rehabilitation protocol should be used with all patients to promote post-injection uniformisation. These steps will yield unambiguous comparisons between future studies and more accurate information on the true potential of PRP. Future studies should also include adverse effects, patient satisfaction, cost effectiveness, and quality of life measures among the primary outcomes.