Amniotic tissueâ“derived allografts for treatment of plantar fasciitis

Centre for Reviews and Dissemination Health Technology Assessments - CRD HTA
Centre for Reviews and Dissemination
Publication date:
04 January 2017


This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA databaseXAO: Plantar fasciitis (PF) is the most common cause of plantar heel pain in the United States. Although most patients with PF respond to conservative therapies, 5% to 20% develop chronic PF, which is a degenerative (rather than inflammatory) condition. Surgical therapies are available but have only modest rates of success and are associated with substantial complications. Description of Technology: This health technology assessment focuses on the use of injectable amniotic tissueâ“derived allografts for treatment of chronic PF. Proponents of amniotic tissueâ“derived allografts suggest that fetal tissues (the placental membranes) have unique healing properties not found in normal adult tissues. Fetal tissues have low immunogenicity and contain prostaglandins, cytokines, peptides, vasoactive growth factors, extracellular matrix proteins, collagen, elastin, and antiinflammatory components that promote epithelialization and regeneration of damaged tissue and limit inflammation and formation of scar tissue. The fetal membranes have been used to treat chronic wounds, prevent adhesions, and promote healing and regeneration of nerves and bone. Amniotic tissues may be obtained when performing elective cesarean sections for healthy pregnancies, then cleansed, sterilized, and processed. Patient Population: The focus of this health technology assessment is on amniotic tissueâ“derived allografts for the treatment of patients with chronic PF who have not responded to conservative treatments. Clinical Alternatives: A number of noninvasive treatments exist for PF. These include local application of ice, rest, taping, nonsteroidal anti-inflammatory drugs, orthotic shoe inserts, night splints, immobilization, weight loss, and physical therapy such as stretching. If conservative therapies do not achieve pain relief, alternative therapies may be warranted and include injectable therapies such as platelet-rich plasma, corticosteroids, botulinum toxin, extracorporeal shockwave therapy, and plantar fasciotomy