# Therapeutic Role of Concentrated Growth Factors in the Management of Chronic Heel Tendinopathies: A Prospective Interventional Study

## TL;DR

This study shows that concentrated growth factor injections significantly reduce pain and improve function in patients with chronic heel tendinopathies.

## Contribution

The study provides empirical evidence for the efficacy of concentrated growth factors in treating chronic heel tendinopathies.

## Key findings

- CGF injections led to significant pain reduction and functional improvement over six months.
- Patients with plantar fasciitis showed the most pronounced improvement.
- No major complications were observed in the study.

## Abstract

Background

Chronic heel tendinopathies, including plantar fasciitis, Achilles tendinopathy, retrocalcaneal bursitis, and Haglund deformity, are among the most common causes of persistent heel pain and functional limitation in adults. Increasing evidence suggests that these conditions represent degenerative failed-healing responses rather than purely inflammatory processes, which explains the limited long-term effectiveness of conventional anti-inflammatory therapies. Concentrated growth factors (CGFs), a second-generation autologous platelet concentrate, provide a dense fibrin matrix enriched with biologically active growth factors that may enhance tendon regeneration and functional recovery.

Objective

To evaluate the clinical efficacy and safety of autologous concentrated growth factor injections in the management of chronic heel tendinopathies refractory to conservative treatment.

Methods

A prospective interventional study was conducted on 50 adult patients (>30 years) diagnosed with chronic heel tendinopathies of more than three months’ duration who had failed standard conservative management. Autologous CGF was prepared from venous blood without anticoagulants and injected locally at the site of maximal tenderness under aseptic conditions. Clinical outcomes were assessed using the Visual Analogue Scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) score for functional evaluation at baseline, one month, three months, and six months post-injection. Statistical analysis was performed using paired t-tests or Wilcoxon signed-rank tests as appropriate, with a p-value <0.05 considered statistically significant.

Results

The mean baseline VAS score of 7.30 ± 0.89 demonstrated a statistically significant reduction to 5.52 ± 0.65 at one month and to 3.94 ± 0.79 at three months (p < 0.001), with sustained improvement observed at six months. Functional outcomes improved in parallel, with AOFAS scores progressing from poor baseline levels (≤53) to good and excellent categories at subsequent follow-ups. The most pronounced clinical improvement was observed in patients with plantar fasciitis, though favorable outcomes were noted across all diagnostic subgroups. No major complications, including infection or tendon rupture, were recorded.

Conclusion

Autologous concentrated growth factor injections provide significant and sustained pain relief and functional improvement in patients with chronic heel tendinopathies. By addressing the underlying degenerative pathology, CGF therapy represents a safe and biologically rational regenerative treatment option. Further randomized controlled trials with larger sample sizes are recommended to establish definitive treatment guidelines.