The use of PRP in treatment of Achilles Tendinopathy: A systematic review of literature. Study design: Systematic review of literature

Madhi, Imad; Yausep, Oliver Emmanuel; Khamdan, Khadija; Trigkilidas, Dionysios

doi:10.1016/j.amsu.2020.04.042

Cited by 34 publications

(25 citation statements)

References 21 publications

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“…Together, these data suggest that injections of PRP at the site of tendinopathy could stimulate the production of collagen by tenocytes to accelerate tendon healing and could inhibit inflammation, limiting the release of pro-inflammatory IL-6 and increasing the production of IL-10. Although laboratory data and open-label studies or retrospective series showed promising results of intra-tendinous injections of PRP in chronic AT, randomized controlled trials failed to demonstrate a superior clinical efficacy compared to saline injection [ 43 , 44 ]. There was no difference in terms of ultrasound lesions (tendon thickness and Doppler activity).…”

Section: Ultrasound-guided Injectionsmentioning

confidence: 99%

Molecular and Structural Effects of Percutaneous Interventions in Chronic Achilles Tendinopathy

Darrieutort-Laffite

Soslowsky

Goff

2020

IJMS

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Achilles tendinopathy (AT) is a common problem, especially in people of working age, as well as in the elderly. Although the pathogenesis of tendinopathy is better known, therapeutic management of AT remains challenging. Various percutaneous treatments have been applied to tendon lesions: e.g., injectable treatments, platelet-rich plasma (PRP), corticosteroids, stem cells, MMP inhibitors, and anti-angiogenic agents), as well as percutaneous procedures without any injection (percutaneous soft tissue release and dry needling). In this review, we will describe and comment on data about the molecular and structural effects of these treatments obtained in vitro and in vivo and report their efficacy in clinical trials. Local treatments have some impact on neovascularization, inflammation or tissue remodeling in animal models, but evidence from clinical trials remains too weak to establish an accurate management plan, and further studies will be necessary to evaluate their value.

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Section: Ultrasound-guided Injectionsmentioning

confidence: 99%

Molecular and Structural Effects of Percutaneous Interventions in Chronic Achilles Tendinopathy

Darrieutort-Laffite

Soslowsky

Goff

2020

IJMS

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“…The authors found that PRP treatment produced satisfactory results in young patients with recalcitrant noninsertional AT, reducing pain and improving function, but was less effective in older patients. 30 In a systematic review, Madhi et al 22 suggested promising results from the use of PRP, but they argued that there was a need for more RCTs to produce better, more accurate results. This is in line with the findings of Di Matteo et al, 12 who reported a paucity of high-level literature on the application of PRP in the management of tendinopathy for both the patellar and Achilles tendons.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Microtenotomy or Physical Therapy for Achilles Tendinopathy: Results of a Randomized Clinical Trial

Al-Ani

Meknas

Kartus

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Achilles tendinopathy is a painful disorder, and various treatment options are available. Bipolar radiofrequency microtenotomy (RFM) has shown promising results in treating tendinosis. Purpose/Hypothesis: The purpose was to compare the results between treatment with bipolar RFM and physical therapy (PT) for patients with midportion Achilles tendinopathy. It was hypothesized that RFM would be equivalent or superior to PT. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 38 patients with midportion Achilles tendinopathy were evaluated for 2 years. The patients were randomized to receive either RFM or PT. There were 20 patients in the RFM group and 18 patients in the PT group. Clinical outcomes were assessed using the visual analog scale (VAS) for pain and the Foot and Ankle Outcome Score (FAOS). The degree of tendinosis was evaluated with magnetic resonance imaging (MRI) of the affected ankle performed before intervention and 2 years after intervention. Results: In both groups, the VAS scores at the 2-year follow-up were significantly improved compared with preintervention: from 7.2 ± 1.5 to 1.0 ± 1.4 for the RFM group and from 5.9 ± 1.3 to 3.1 ± 1.8 for the PT group ( P < .01 for both). Compared with the PT group, the RFM group had significantly better VAS scores at both the 1- and 2-year follow-ups ( P < .01 for both) and better scores on 4 of the 5 FAOS subscales at the 2-year follow-up ( P < .01 for all). MRI revealed an improvement in the tendinosis score in both groups, without any significant difference between the groups. Conclusion: In this randomized study, the clinical assessments revealed significant improvements in the VAS, FAOS, and tendinosis score as seen on MRI 2 years after intervention with either RFM or PT in patients with midportion Achilles tendinopathy. The improvement was significantly better in the RFM group with regard to VAS and FAOS, but not in the MRI appearance. Registration: NCT03274557 ( ClinicalTrials.gov identifier).

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“…Therefore, it has a major impact on athletes and there is a need for an accelerated and performant healing strategy. PRP is gaining increasing attention as an adjuvant for tendon healing and its safety has been established [10,12,[14][15][16]24,29,39]. It is emerging for its use in ATR and in other pathologies such as epicondylitis and rotator cuff injuries [12,14,[29][30][31]40].…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have enhanced the interest of PRP in tendon and ligament pathologies, especially in partial rotator cuff tear [14]. However, no benefit has been clearly shown in chronic Achilles tendinopathy [15]. In a systematic review, Filardo et al [16] assessed the use of PRP in tendon-related disorders and more specifically Achilles tendon rupture.…”

Section: Introductionmentioning

confidence: 99%

Interest of platelet rich plasma in Achilles tendon rupture management: a systematic review

Daley

Louguet³

et al. 2021

The Physician and Sportsmedicine

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Objectives: Acute Achilles tendon rupture (ATR) is a disabling sport-related injury. Its management involves conservative treatment with early weight-bearing or surgical treatment.Platelet-rich plasma (PRP) has raised interest as an adjuvant for treatment, given its properties on tendon repair and its anti-inflammatory effect. We aimed to assess clinical impact of PRP use in surgical or non-surgical treatment of acute ATR: range of motion, muscle strength, function, return to sport and adverse events.Method: A systematic literature research was performed using PubMed, ScienceDirect, and Google Scholar databases to collect studies reporting clinical outcomes after acute ATR treated with PRP.Results: Eight studies were eligible and included 543 acute ATR. Four were randomized comparative studies. A total of 128 patients were treated surgically and 415 were treated conservatively, 271 received PRP injection. Five studies described the type of PRP used, which was variable. Only one study including 12 patients found significant outcomes in favor of the PRP group, with a 4-week earlier recovery of a normal range of motion and a 7-week earlier return to running. No difference in clinical or morphological evaluations, strength measurement, and functional outcomes was found in other studies both at short and longterm. PRP did not seem to modify the frequency of adverse events. Conclusions: Data are not clearly in favour of a significant effect of the PRP use for treatment of ATR. There might be a slight effect on evolution during the first months. Its interest should be assessed in future studies with strong methodology.

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The use of PRP in treatment of Achilles Tendinopathy: A systematic review of literature. Study design: Systematic review of literature

Cited by 34 publications

References 21 publications

Molecular and Structural Effects of Percutaneous Interventions in Chronic Achilles Tendinopathy

Molecular and Structural Effects of Percutaneous Interventions in Chronic Achilles Tendinopathy

Radiofrequency Microtenotomy or Physical Therapy for Achilles Tendinopathy: Results of a Randomized Clinical Trial

Interest of platelet rich plasma in Achilles tendon rupture management: a systematic review

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