Bone Marrow Aspirate Versus Platelet-Rich Fibrin for the Treatment of Chronic Plantar Fasciitis

Inclusion Criteria: * Adults aged 18 to 75 years. * Clinical diagnosis of chronic plantar fasciitis for more than 6 months, confirmed by ultrasonography (increased plantar fascia thickness and hypoechogenicity). * Persistent heel pain refractory to conventional conservative treatment (stretching, orthotics, physical therapy, or corticosteroid injections). * Visual Analog Scale (VAS) pain score ≥ 4 at baseline. * Ability and willingness to comply with study procedures and follow-up assessments. * Signed informed consent. Exclusion Criteria: * Previous foot or ankle surgery on the affected limb. * Acute trauma, infection, or ulceration in the region of the plantar fascia. * Systemic inflammatory diseases (e.g., rheumatoid arthritis, lupus, psoriatic arthritis). * Metabolic or endocrine disorders interfering with healing (e.g., diabetes mellitus with poor glycemic control, thyroid disorders). * Current use of systemic corticosteroids, immunosuppressants, or anticoagulants. * Active neoplasia or hematologic disorders. * Pregnancy or breastfeeding. * Peripheral vascular disease or neuropathy affecting the lower limbs. * Contraindications to local anesthesia or venipuncture.