Outcomes of prolotherapy for intra-tendinous Achilles tears: a case series

Chan, Otto; Havard, B.; Morton, Sarah; Pritchard, Mel; Maffulli, Nicola; Crisp, Tom; Padhiar, Nat; Perry, Jackie; Jb, King; Morrissey, Dylan

doi:10.32098/mltj.01.2017.11

Cited by 5 publications

(8 citation statements)

References 13 publications

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“…In general, an immobilization of the treatment sites after PRP therapy was recommended or ordered in order to escape the inhibition or the delay of the cellular reparative reactions in clinics for human (28). The present study demonstrated that tendinopathies recovered well in P75 or P100 groups without the immobilizations of the treatment sites after PRP therapy, suggesting that tendinopathies in human might also recover well by the PRP therapy under the condition that the concentrations of platelets in PRP were in the optimal range even though without immobilizations of the treatment sites.…”

Section: Discussionmentioning

confidence: 99%

Optimal Platelet Concentration for The Therapeutic Effect of Autologous Neutrophil-Reduced Platelet Rich Plasma in A Rat Model of Achilles Tendinopathy

Yoshida

Funasaki

2020

Muscle Ligaments and Tendons J

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Background. Autologous Platelet-Rich Plasma (PRP) therapy is used for treatment of tendinopathy. Efficacy, however, is variable, possibly caused by differences in PRP platelet concentrations. In an animal model of tendinopathy, we determined if there was an optimal PRP platelet concentration. Methods. Tendinopathy was induced by collagenase injections into the Achilles tendons in rats. 10 days later, PRP at platelet concentrations of 50 (P50 group), 75 (P75 group), 100 (P100 group) and 150 × 10 4 /µL (P150 group) or normal saline (control group) was injected into the tendons. To assess pain relief, spontaneous locomotor activity was measured for 12 hours at night. After 19 days, Achilles tendons were removed, and histological sections stained with hematoxylin-eosin or by TdT-mediated dUTP nick end labeling. Results. Activities in the P75 and P100 groups were significantly greater than in the P50, P150 and control groups. The numbers of microtears, laminations and apoptotic cells in tendons in the P75 and P100 groups were significantly fewer than in the P50, P150 and control groups. Conclusions. Pain relief and tendon repair were greatest in the P75 and P100 groups. In this rat model of tendinopathy, the optimal PRP platelet concentration in PRP was approximately a range of 75 to 100 × 10 4 /µL.

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Section: Discussionmentioning

confidence: 99%

Optimal Platelet Concentration for The Therapeutic Effect of Autologous Neutrophil-Reduced Platelet Rich Plasma in A Rat Model of Achilles Tendinopathy

Yoshida

Funasaki

2020

Muscle Ligaments and Tendons J

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“…There are nine studies (52%) used the concentration of dextrose with 25% [8,9,12,14,16,17,22,23,28] while three studies each used concentrations with 20% [11,15,18] or 15% [19][20][21]. The other two studies used concentrations of 10% [23] and 16.5% [13].…”

Section: Concentration Of Dextrose and Injection Protocolmentioning

confidence: 99%

“…The other two studies used concentrations of 10% [23] and 16.5% [13]. Most of study (15 studies/88%) reported dextrose mixed with lidocaine, and only one study used a mix with saline [8] or marcaine [28].…”

Section: Concentration Of Dextrose and Injection Protocolmentioning

confidence: 99%

Dextrose Prolotherapy for Muscle, Tendon and Ligament Injury or Pathology: A Systematic Review

Рhatomy

Margaretha

Rahmadian

2020

ARRB

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Background: Prolotherapy with dextrose has recently gained attention as a potential treatment for muscle, ligament or tendon pathology/injury. Questions/Purpose: This review aimed to: 1) evaluate the main outcome of dextrose prolotherapy treatment for muscle, ligament or tendon pathology/injury; 2) determine the concentrations of dextrose and protocol of injection; and 3) assess complications or adverse effects after dextrose prolotherapy. Methods: Four electronic databases were searched for related published articles. Articles that met the following criteria were included in this review: 1) articles on peer-reviewed level 1 to 4 studies; 2) articles published in English; 3) articles on dextrose prolotherapy study for tendon or ligament or muscle injury/pathology; and 5) articles that describe dose of dextrose. Published articles that met this inclusion criteria were included in this systematic review. Results: Twenty four studies fulfilled inclusion criteria,consisting of seventeen clinical studies, four animal studies and three invitro studies. Eleven studies reported there were improvement of functional outcome after dextrose prolotherapy. Three Studies reported improvement of patient satisfaction after dextroprolotherapy in supraspinatus tear, Achilles tendinopathy. And patellar tendinopathy, meniscus tear and anterior tibiofibular ligament tear. Three studies reported there are increasing of neovascularization in Achilles tendinopathy and patellar tendinopathy in animal studies, increasing of inflammatory response in animal studies and in vitro studies and increasing of cell proliferation and collagen production. Nine studies (52%) use dextrose 25% concentration. A few adverse effects were reported and minor effect, such as discomfort Minor soreness, extreme pain, skin burns 2nd grade, hypotension, Deep Vein Thrombosis (DVT) ( patient has history DVT). Conclusions: Dextrose Prolotherapy is a potentially effective treatment for patients with muscle, tendon or ligament tear or pathology. Efficacy in long term follow-up, as single therapy or first-line therapy cannot be determined from the current literature.

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“…Anecdotally, this is not something we have discovered. Research into suggested treatment techniques have already been undertaken 32 . Despite this study being retrospective, the Authors did have the benefit of saved images and videos when compiling the data, along with the ultrasound reports.…”

Section: Future Research and Limitationsmentioning

confidence: 99%

Conservative, minimally invasive and open surgical repair for management of acute ruptures of the Achilles tendon: a clinical and functional retrospective study

Maffulli

Buono

Richards

et al. 2019

Muscle Ligaments and Tendons J

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Background: Achillodynia is common and includes Achilles tendinopathy, partial Achilles tears and Achilles tendon ruptures. However, we believe an additional pathology should be considered for Achillodynia differentials -the intratendinous tear (ITT). Methods: Examinations of 740 achillodynic patients in one specialist centre were reviewed. ITTs were defined as a clearly visualised echopoor area situated centrally and extending to, but not through the tendon periphery, with pain on palpation and no clinical findings consistent with Achilles rupture. Descriptive statistics were used to analyse differences between pathological sub-groups, and images described qualitatively. Results: 5% (29 males, 8 females) of 740 patients had an ITT. Patients typically presented with a history of sudden onset localised pain and the ability to train but not reach maximal loading. Average age was 36. 3 years (range 20-64), significantly lower than mid-tendon tendinopathy (8.48 years; p<0.01). 92% had concurrent Achilles tendinopathy. Elite sportspeople were more highly represented in the ITT than mid-tendon tendi nopathy groups (86.2% ITT group vs 13.8% mid-tendon AT group; p<0.01). Conclusions: ITTs should be actively searched for in patients with Achilles pathology, especially in elite male athletes with a history of high-impact pain. Prospective research is warranted concerning diagnosis and management. Level of evidence: IV.

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Outcomes of prolotherapy for intra-tendinous Achilles tears: a case series

Cited by 5 publications

References 13 publications

Optimal Platelet Concentration for The Therapeutic Effect of Autologous Neutrophil-Reduced Platelet Rich Plasma in A Rat Model of Achilles Tendinopathy

Optimal Platelet Concentration for The Therapeutic Effect of Autologous Neutrophil-Reduced Platelet Rich Plasma in A Rat Model of Achilles Tendinopathy

Dextrose Prolotherapy for Muscle, Tendon and Ligament Injury or Pathology: A Systematic Review

Conservative, minimally invasive and open surgical repair for management of acute ruptures of the Achilles tendon: a clinical and functional retrospective study

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