title: Clinical and magnetic resonance imaging outcomes following platelet rich plasma injection for chronic midsubstance Achilles tendinopathy.
abstract: BACKGROUND
  The successful treatment of chronic mid-substance Achilles tendinopathy remains elusive. Approximately 25% to 50% of patients fail conservative treatment modalities. Scientific evidence has supported the use of platelet rich plasma (PRP) in the tendon healing process, however despite initial promise there is a paucity of clinical data to validate a role for PRP in the treatment of tendon disorders including chronic midsubstance Achilles tendinopathy.
  
  
  METHODS
  As an alternative to operative treatment, our practice offers patients with chronic midsubstance Achilles tendinopathy intratendinous injection of PRP. We retrospectively reviewed all patients treated for Achilles tendinopathy with PRP injection over a 2-year period. Baseline and post injection functional scores including the Foot and Ankle Ability Measure (FAAM), Foot and Ankle Ability Measure - Sports (FAAMS), and the Short Form health survey (SF-8) were examined. Patients also underwent post-injection magnetic resonance imaging (MRI), which were compared to available pre-injection MRI data.
  
  
  RESULTS
  Ten patients were identified for this study. Pre- and postinjection functional outcome scores were available for eight of ten patients. The average SF-8 score improved from 24.9 to 30.0, the average FAAM score improved from 55.4 to 65.8, and the average FAAMS score improved from 14.8 to 17.4. Complete MRI data was available for six patients. Only one in six Achilles tendons demonstrated qualitative MRI improvement post-injection.
  
  
  CONCLUSIONS
  Patients who received PRP injection demonstrated modest improvement in functional outcome measures, however MRI appearance of diseased Achilles tendons remained largely unchanged following PRP injection.
authors.affiliation: Southern Oregon Orthopedics, Orthopaedic Surgery, 2780 E. Barnett Road, Suite 200, Medford, OR 97504, USA. owensrf1969@gmail.com
authors.forename: Richard F
authors.initials: RF
authors.lastname: Owens
authors.forename: John
authors.initials: J
authors.lastname: Ginnetti
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Conti
authors.forename: Carmen
authors.initials: C
authors.lastname: Latona
mesh_terms: D000125:Achilles Tendon; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D012189:Retrospective Studies; D052256:Tendinopathy / Q000188:drug therapy*; D016896:Treatment Outcome