Clinical Outcomes Following Platelet-Rich Plasma Injection for Plantar Plate Injuries at Midterm Follow-up.

BACKGROUND: Evidence supporting platelet-rich plasma (PRP) injection for plantar plate injuries remains limited. PURPOSE: To evaluate patient-reported outcomes, return to activity, complications, and failures at midterm follow-up in patients with plantar plate injuries treated with PRP injection. STUDY DESIGN: Retrospective case series evaluating outcomes following PRP injection for plantar plate injuries. METHODS: Patients with plantar plate injuries were treated with ultrasound-guided PRP injection following failure of nonoperative management. Clinical outcomes evaluated were Foot and Ankle Outcome Score (FAOS) and Visual Analog Scale (VAS). Complications and failures were also reported. RESULTS: Twenty patients (23 feet) with a mean age of 51.0 ± 14.5 years and mean follow-up time of 58.0 ± 28.4 months were included. Mean FAOS scores improved 32.2 points (p < 0.001), with 20 of 23 (87%) feet achieving the minimal clinically important difference (MCID). Mean VAS scores improved 4.5 points (p < 0.001), with 19 of 23 (83%) feet achieving the MCID. Among 10 athletes, 7 (70%) returned to sport at a mean time of 3.1 ± 1.1 months. Complications occurred in 1 of 23 (4%) feet, and 3 of 23 (13%) feet required subsequent surgical intervention. CONCLUSIONS: At midterm follow-up, PRP injection for plantar plate injuries was associated with significant clinical improvement and a favorable safety profile, suggesting a potential role as an intermediary treatment option between conservative management and surgery. Female sex, smoking history, and higher-grade injuries were associated with inferior outcomes, underscoring the importance of individualized patient counseling and injury severity assessment. LEVEL OF CLINICAL EVIDENCE: IV, retrospective case series.