Autologous Fat Transfer: Plantar Fasciitis

What is plantar fasciitis?

Plantar fasciitis is a very common cause of heel pain. This occurs due to the inflammation of the thick tissue band situated across the bottom of the feet. This band of thick tissue is known as the plantar fascia ligament and connects the heels to the toes. It absorbs shock and supports the arch of the foot. Plantar fasciitis is caused to wear and tear to the plantar fascia ligament. The symptoms of plantar fasciitis include burning or ache on the bottom of the foot. Climbing stairs, the first step after a long time of sitting or laying down, or after prolonged activity, the pain may flare up due to increased irritation of the ligament. Sometimes the pain is felt right after activity and not usually during it. Many people that suffer from plantar fasciitis are active men and women between the ages of 40 and 70. Women are also more prone to this inflammation compared to men. People in the late stages of pregnancy or with obesity are at an increased risk of developing plantar fasciitis. More active workers, such as warehouse workers have an increased risk. Other factors such as wearing shoes with poor arch support and with soft soles may result in plantar fasciitis. 


Common Treatments of Plantar Fasciitis: 

Treatment of plantar fasciitis depends on the severity of the inflammation. Although most common treatment plans may include using braces, anti-inflammatory drugs, or physical therapy. Doctors may also recommend ultrasound-guided corticosteroid injections to treat plantar fasciitis. In the case of chronic plantar fasciitis, doctors proceed with surgical procedures such as open fasciotomy and endoscopic plantar fasciotomy. These surgeries are invasive and include cutting the plantar fascia, which has the potential to destabilize the foot, increasing scar tissue development, and other problems. These surgeries come with other complications such as nerve damage, numbness, deep vein thrombosis with immobilization, lateral foot stress reaction, scar formation, calcaneal cuboid syndrome, and requires a prolonged recovery. Alternative treatments such as steroid injections can lead to fascia rupture and heel fat atrophy. A novel procedure that is used in treatments of osteoarthritis issues and rejuvenation procedures called Autologous Fat Transfer has proved to improve plantar fasciitis. 

How can Autologous Fat Transfer treat Plantar Fasciitis? 

Autologous Fat Transfer (AFT) is a safer method to help reduce osteoarthritis pain, and plantar fasciitis can also be treated by the perforating gat injections into the substance of the thickened plantar fascia ligament. AFT includes the harvesting of adipose tissue, most commonly known as fat tissue from the patient. The fat is harvested typically from the flanks via tumescent liposuction and processed.  After the processing of the adipose tissue, that is rich in ADSCs (Adipose tissue-derived stem cells), it can be injected into the medial band of the plantar fascia. This procedure is done using ultrasound guidance and therefore the inflammation area can be monitored. AFT is noninvasive and shows promise as a novel treatment option to treat chronic plantar fasciitis. The risk of destabilization or scar tissue development is nonexistent as it is only an injection that goes into the plantar fascia. The donor and recipient of the tissue is the same patient and so consequently is beneficial for the rejuvenation of the damaged ligament without much complication or risk of rejection. A clinical trial at the University of Pittsburgh aimed to determine whether performing fat injections to the plantar fascia is a safe method to improve pain, quality of life, and reduce plantar fascia thickness. This trial was able to prove this hypothesis and proved the safety and effectiveness of fat propertied pf lipoaspirate to improve in the function of plantar fascia thickness. The growth factors present in the adipose tissue-derived stem cells proved to have a local effect on the soft tissue that promotes regenerative healing rather than scar formation, ultimately improving the thickness of plantar fascia. 

 

If you have further questions about Autologous Fat Transfer for plantar fasciitis or want to schedule an appointment, call our office at (609) 587-9944 or e-mail us at info@sleep-wellness.org.

 

 

References:

https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846 

 

https://www.healthline.com/health/plantar-fasciitis#:~:text=The%20plantar%20fascia%20is%20a,the%20most%20common%20orthopedic%20complaints

 

https://www.podiatrytoday.com/what-you-should-know-about-perforating-fat-injections-chronic-plantar-fasciitis  

 

https://ichgcp.net/clinical-trials-registry/NCT02855983 

Author
Anuva Nabiha Anuva is a Boston University undergraduate studying neuroscience in the premedical track. She believes in the importance of mental health in the healthcare system and wants to focus on overcoming the bias against BIPOC in medical science.

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